Ulcerative colitis (UC) is an inflammatory bowel disease, characterized by chronic relapsing intestinal inflammation. The incidence of UC has increased in Northern Europe, North America, Asia, and Africa, suggesting an environmental factor for its pathogenesis. Additional factors for its development are antibiotic exposure, diet, and genetics. The hallmark of the disease is mucosal inflammation that involves the rectum and extends continuously throughout the colon. Medical management is the first step in treatment, followed by surgery for intractable disease, fulminant colitis, massive bleeding, perforation, or malignancy.