Idiopathic inflammatory bowel disease requires complex treatment and patients are often considered to undergo the surgery in the course of therapy. Though the conservative treatment of the Crohn's disease and ulcerative colitis has no major differences, the strategy of surgical treatment and the extent of the operation are in these two diseases markedly different. In an aforethought patient in the clinically and metabolically good shape, the postoperative morbidity and mortality is much lower. It is therefore desirable to do the most of surgeries as elective, though such goal is not always achievable. Beside the appropriate time for the operation, the surgery should be done in the most proper extent, therefore with the maximal care and considering the type and activity of the disease also with the sufficient curative effect. As the surgical therapy of idiopathic inflammatory bowel diseases requires profound experience in order to choose the correct type of operation, the close collaboration between the gastroenterologist and surgeon is necessary and should be performed preferably at specialized departments.