Inflammatory bowel disease is considered to be rare or nonexistent in some Arab countries. During a period of 6 years, 91 patients with ulcerative colitis and 17 with Crohn's disease were seen for initial diagnosis in the Gastroenterology Department of Amiri Hospital, which serves 55% of the population of Kuwait. From this group, 43 patients with ulcerative colitis and 14 patients with Crohn's disease were followed up for an average of 30.9 months. In the remaining 51 patients, the diagnosis was established in the same manner as in this series, but these patients were sent back to the referring physicians and therefore were not available for follow-up. The severity of the disease in the majority of patients with ulcerative colitis was mild to moderate. Nine of 14 patients with Crohn's disease underwent surgery as a diagnostic procedure in an acute abdominal emergency or for treatment of complications. The duodenum was involved in two patients with Crohn's disease and the endoscopic picture and histology of these were initially interpreted as immunoproliferative small intestinal disease which is highly prevalent in this area. We suggest that the assumption that inflammatory bowel disease is uncommon in our population is wrong.