Enteropathic arthritis refers primarily to arthritis caused by two inflammatory bowel diseases, ulcerative colitis and Crohn’s disease. Ulcerative colitis and Crohn’s disease together are collectively referred to as inflammatory bowel disease. Enteropathic arthritis is immune-related and often invades the joints of the extremities and spine, and the joints involved are predominantly large joints of the lower extremities with unilateral, asymmetric features and negative for rheumatoid factor in the blood, so it is included in seronegative spondyloarthropathies along with ankylosing spondylitis, Wright’s syndrome, psoriatic arthritis, and reactive arthritis. In most patients, bowel symptoms occur before or simultaneously with the joint lesions, and in some patients the joint lesions occur several years before the bowel lesions. Peripheral arthritis occurs in approximately 17-20% of patients with enteropathic arthritis and presents as few joints, asymmetric, transient and wandering, and alternating between recurrence and regression. Involvement of large joints and lower extremity joints is more common than involvement of small joints and upper extremity joints. Rachnoid finger (toe), tendon telangiectasia, especially Achilles tendinitis and plantar fasciitis are seen. Crohn’s disease arthritis and may be seen with pestle fingers (drum-like fingers) and osteochondritis. Enteropathy is the basis of enteropathic arthritis, and treatment should logically begin with control of enteropathy. Non-steroidal analgesic and anti-inflammatory drugs can improve joint symptoms, but attention should be paid to the side effects of the drugs on the pre-existing diseased bowel. Sulfasalazine has been shown to be useful in the treatment of ulcerative colitis, peripheral arthritis, and spondylitis, which is a double whammy. Corticosteroids can control intestinal disease and reduce peripheral arthritis, but are not effective for spondylitis and sacroiliac arthritis.