In the past year, there has been an increased emphasis on developing improved methods and assessment of inflammatory bowel disease. Although tumor necrosis factor-α may be useful in the evaluation of inflammatory bowel disease in children, some controversy remains. Other serum markers, such as procollagen type I and type III, appear to be useful as early indicators of growth or inhibition of growth with treatment and activity. The use of steroid-sparing drugs continues to be studied, with new reports of pediatric inflammatory bowel disease responding to cyclosporine, 6-mercaptopurine, azathioprine, and alternate-day prednisone. Long-term studies are reported on outcome and recurrence in children with Crohn's disease following surgery, the development of inflammatory bowel disease in the offspring of couples with inflammatory bowel disease, and the psychologic difficulties that arise in children and families of children with inflammatory bowel disease. Other diseases that may be confused with pediatric inflammatory bowel disease are also reviewed.