The coexistence of inflammatory bowel disease and pregnancy poses a major clinical challenge. The present article analyzes data on the mutual influence of the two entities, the effect of the disease and its pharmacological treatment on maternity, paternity, delivery and breast-feeding, the modifications that may be required during delivery, and the influence of the disease on fertility and sexuality, among other factors. The most important conclusions are the strong recommendation that inflammatory bowel disease be inactive when planning a pregnancy, that most drugs can be safely used (with the notorious exception of methotrexate, among others) and that reproduction does not need to be limited in these patients.