Pulmonary involvement seems to be a more frequent extraintestinal manifestation of IBD than thus far supposed. In IBD, the respiratory involvement may include a wide range of pathologies. The patients with IBD are in high risk of infections. The drugs used in the treatment of IBD (sulfasalazine, mesalamine, infliximab, and methotrexate) can induce pulmonary diseases as a side effect.Pulmonary function tests and high resolution CT are useful for detecting subclinical or clinical pulmonary involvement in IBD patients. Pulmonary function tests (PFT) and high-resolution CT (HRCT) showed abnormality in about one-quarter of patients with IBD. Corticosteroids, both systemic and aerosolized, are the main therapeutical approach, while antibiotics must also be administered in infections. Early identification is important as early treatment may improve long-term outcomes in these patients.