Treatment of patients with inflammatory bowel disease has been focused but is also currently focused on symptomatic relief and clinical improvement. However, since the course of IBD may progress from an inflammatory to a stricturing and penetrating type of disease with a high rate of bowel surgery ), early and sufficient treatment strategies to protect the mucosal integrity and therefore prevent disease progression are warranted. Colonoscopy is the gold standard for diagnosing mucosal injury in IBD patients and to evaluate the efficacy of therapy. Various endoscopic scores are used in clinical practice and clinical studies to assess the mucosal status in IBD patients. Since routine surveillance colonoscopy in asymptomatic IBD patients without dysplastic lesions depending on the severity and type of IBD are recommended only every 2-15 years, the mucosal status after initiation or maintenance of a new therapy often remains unclear in most of these patients. Moreover, willingness for control colonoscopy in asymptomatic patients is low. There is growing evidence, that mucosal healing is associated with a better long-term outcome, lower need for surgeries and hospitalisation and improved quality of life in IBD patients. Moreover, in a statement of the European Crohn’s and Colitis Organization regarding the impact of MH on the course of IBD, the need for further studies was addressed. Therefore, we aimed to analyze in this study the real-life prevalence and predictive factors of mucosal healing in IBD patients treated with anti-TNF-alpha antibodies in a large single center cohort. Mucosal healing in patients with IBD is an important treatment goal, leading to better long-term remission rates, better quality of life, lower need for hospitalisation and surgeries, and lower rates of colorectal cancer. MH can be achieved with various treatment strategies including immunosuppressive therapies such as methotrexate or thiopurines and anti-TNF-alpha antibodies. Former studies have demonstrated that corticosteroids are not suitable for maintenance of mucosal healing, and combination therapy with thiopurines and anti-TNFalpha antibodies is superior compared to thiopurine monotherapy in CD regarding remission rates and MH. Emerging data indicate that early use of anti-TNF-alpha antibodies lead to better long-term outcome in IBD patients by preventing mucosal damage. However, results from prospective large-scale studies are still very limited. The anti-TNF-alpha antibodies infliximab and adalimumab have the potential to induce and maintain MH in IBD. Moreover, there is evidence that early infliximab-induced MH is associated with a better long-term outcome and a lower need for major abdominal surgeries in CD and UC. A recent retrospective analysis demonstrated that infliximab induced MH in 45% of CD patients 3 months after start of inflixmab which was highly predictive for MH after 12 months.