The editorial focuses on advances in precision medicine in childhood-onset inflammatory bowel disease (IBD). Precision medicine is necessary for the rational selection and optimization of therapies with a wider but still limited supply of drugs. Growing knowledge of the clinical, genetic, microbial and proteomic characteristics of patients allows better tailoring of treatment to individuals. In the field of pediatric IBD, there is a renaissance of new diagnostic, prognostic, and therapeutic procedures, including drug monitoring and tumor necrosis factor inhibitors. Includes Crohn's disease and ulcerative colitis in children and adolescents. Precision medicine helps predict response to biologic treatments such as vedolizumab based on molecular imaging. Future directions include validation in multicenter studies on larger patient groups.[1][3]