Objectives: The purpose of this study was to retrospectively compare color Doppler Ultrasonography (CD-US) and diffusion weighted Magnetic Resonance Enterography (DWI-MRE) in the evaluation of disease severity of pediatric inflammatory bowel diseases (IBD). Materials and methods: During the period between February 2010 and November 2012, 36 patients affected by IBD, aged between 7.8 and 18.5 years (mean 11.9 years) underwent, in the same week, CD-US, DWI-MRE [completed by apparent diffusion coefficient (ADC) calculation] and ileocolonoscopy with intestinal biopsies. Overall, 53 bowel segments (27 ileal, 26 colonic) were examined. At CD-US evaluation, a wall thickness > 3 mm in the small bowel and >2 mm in the large bowel, associated with an increased intramural vascularity, were considered abnormal. ADC values were significant when lower than 2 × 10 −3 mm 2 /sec. Histopathological grading of inflammation distinguished between active (mild, moderate and severe) and inactive disease. For each segment, CD-US findings and ADC values were compared with histology. Results: CD-US correctly graded 46/53 cases (86.8%) as compared with histology. Statistical analysis demonstrated a negative correlation between ADC