Background <p>Inflammatory bowel disease (IBD)is associated with extraintestinal manifestations, notably venous thromboembolism (VTE), a major cause of morbidity and mortality. Patients with IBD have a 2- to 4-fold increased risk of VTE compared to the general population. Large-scale studies examining associations between VTE and adverse outcomes in hospitalized IBD patients are limited. This study aimed to investigate associations between VTE and mortality (in-hospital and overall) in hospitalized patients with IBD.</p> Methods <p>This retrospective cohort study included the data of 2790 adults hospitalized with IBD extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) v.3.1 Database, 2008 to 2022. IBD diagnosis was determined using ICD-9 and-10 codes. Main study outcomes were in-hospital and overall mortality. Covariates were demographic data, laboratory results, comorbidities, and hospital stays. Logistic regression and Cox proportional hazards models were used to evaluate associations between VTE and mortality, adjusting for confounders.</p> Results <p>Hospitalized patients with IBD who had VTE were significantly older and had lower hemoglobin, RBC count, and sodium levels, and higher Charlson Comorbidity Index (CCI) scores. The VTE group also had significantly longer hospital stays (<i>P</i> &lt; 0.001), higher in-hospital mortality (10.26% vs. 2.28%, <i>P</i> &lt; 0.001), and overall mortality (34.19% vs. 16.01%, <i>P</i> &lt; 0.001). Cox regression analysis showed that VTE was an independent predictor of in-hospital mortality (aHR 2.205, <i>P</i> = 0.021). Long‑term mortality remained significantly higher in the VTE cohort (aHR 1.758, <i>P</i> = 0.001).</p> Conclusion <p>VTE is an independent predictor of in-hospital and long-term mortality in hospitalized patients with IBD.</p>