Purpose of Review <p>Traditional abdominal ultrasound for monitoring inflammatory bowel disease is known as Intestinal ultrasound (IUS). This is a non-invasive, point-of-care imaging tool that is utilized to visualize the bowel wall and its layers. IUS was initially used for assessment of small bowel Crohn’s disease (CD) but has now proven to be just as accurate for colonic disease.</p> Recent Findings <p>IUS can detect disease activity in both ulcerative colitis (UC) and colonic CD with high sensitivity and specificity when compared to colonoscopy. The sonographic parameter of bowel wall thickness (BWT) is key for detecting disease activity. The ease and reproducibility of IUS allows for rapid assessment of treatment response in both outpatient and inpatient settings with changes seen as early as 48&#xa0;h after initiating appropriate treatment. IUS has proven to be useful in special populations, including pregnancy and pediatrics, where traditional methods of monitoring are less feasible or of higher risk.</p> Summary <p>IUS is a useful tool for objective assessment of colonic disease activity in colonic UC or CD.</p>