Abstract
Personalized medicine is increasingly shaping the management of inflammatory bowel disease (IBD), with the goal of tailoring diagnostic and therapeutic strategies to individual patients. Intestinal ultrasound (IUS) has emerged as a pivotal, non-invasive, and repeatable tool for assessing disease activity, treatment response, and complications in both Crohn's disease and ulcerative colitis. Beyond its role in routine monitoring, IUS enables real-time decision-making and facilitates tight control strategies, aligning with the principles of precision medicine. By combining morphological assessment with advanced techniques, such as contrast-enhanced ultrasound and elastography, IUS offers unique opportunities for risk stratification and individualized treatment planning. Moreover, its accessibility, safety, and patient acceptability make IUS particularly suited for longitudinal follow-up and early detection of therapeutic failure, thereby reducing the need for invasive procedures. This review discusses the integration of IUS into personalized IBD care pathways, highlighting current evidence, clinical applications, and future perspectives.