The incidence of inﬂ ammatory bowel disease (IBD) presenting in children is increasing, more than 25 per cent cases are now diagnosed under the age of 18 (Sawczenko et al. 2001). IBD presenting at this age is more extensive and severe than in adults (Van Limbergen et al. 2008; Vernier-Massouille et al. 2008). It interferes with growth, education and employment as well as psychosocial and sexual development. Young people with IBD have lower self-reported health related quality of life, although data on the impact of IBD on self-esteem, depression and anxiety, impaired social competence and behavioural problems in this age group are conﬂ icting. This chapter reviews differences in the course of disease between adolescents and adults with IBD focusing on the impact of IBD on physical as well as psycho-social development. Finally, the evidence that supports the role of transition for patients with IBD will be discussed and different models of care for patients in this age group will be reviewed.