The prevalence and occurrence of inflammatory bowel disease (IBD) have risen significantly around the world. Developing countries face a lot of challenges to deal with inflammatory diseases in human life. There seems to be considerable evidence that oxidative stress (OS) and reactive oxygen species (ROS) are crucial for the formation and advancement of IBD. The biological process of chronic inflammation is extensive and involves both types of immune and nonimmune cells, as well as the endothelial lining of the microvasculature of IBD. This chapter covers all pathological, clinical changes of IBD with causes and symptoms of gastrointestinal (GI) tract disease. IBD occurs from the disturbed function of lymphocytes of immune cells and pro-inflammatory cytokines. The focus of this chapter is to review pathogenesis with emphasis on molecular pathways involved in IBD with strategic drug delivery approaches. Numerous studies have tested new viewpoints on the revelation of atomic focuses for conclusive IBD treatment. © 2024 Elsevier Inc. All rights reserved.