Medical options for Crohn's disease are expanding at an unprecedented rate. The anti-tumor necrosis factor-a (TNF-a) agents infliximab, adalimumab, and certolizumab pegol have proven efficacy for induction and maintenance of remission among patients with moderate to severe Crohn's disease. Anti-TNF therapy has also been successful in reducing the need for corticosteroids, closing fistulas, healing colonic mucosa, and reducing the number of hospitalizations and surgeries. With these tools, the goal of therapy in Crohn's disease may change from the management of symptoms to a change in the natural history of the disease.