Crohn’s disease is an inflammatory disease of the gastrointestinal tract whose etiology is still unclear and is mostly treated internally. The previous view was that surgery should be considered only when the patient presents with the following conditions (complete intestinal obstruction, abscess, entero-abdominal fistula or endovascular fistula, acute perforation, uncontrollable haemorrhage, suspected malignancy, and poor outcome or instead aggravation despite medical treatment). The current view is that surgery should be treated more positively, although it cannot treat all Crohn’s disease, much less cure it. In patients with suspected or diagnosed Crohn’s disease, early surgical intervention may be more beneficial when medical therapy is not effective. This is because: 1. Surgery can clarify the diagnosis as early as possible and provide a basis for further formal comprehensive medical treatment; 2. Removal of the diseased intestinal segment that induces symptoms reduces patients’ pain and improves their quality of life; 3. Reduces the chance of cancer; 4. Early surgery can slow down disease progression and reduce the occurrence of complications; 5. Some foreign reports suggest that surgery before complications occur, the postoperative recurrence rate, the mortality rate is significantly lower than that of emergency surgery. The lack of specific clinical manifestations of Crohn’s disease and the different sites of lesions lead to a variety of clinical manifestations and a high rate of misdiagnosis. Pay attention to the following points to reduce misdiagnosis: 1, raise awareness of the disease, in the clinical encounter of unexplained intestinal obstruction, gastrointestinal bleeding, gastrointestinal perforation, to consider the possibility of Crohn’s disease; 2, to ask a detailed medical history, physical examination should be careful; 3, as soon as possible to perform a full gastrointestinal barium meal examination, enteroscopy to reach the end of the ileum, the condition of the unit and the patient can also consider capsule gastroscopy; 4. During appendectomy, if lesions are found to be inconsistent with clinical manifestations, the possibility of this disease should be considered and the terminal ileum should be routinely explored. Resection of the diseased intestinal segment is currently the most commonly chosen surgical approach, and resection at a distance of 10 to 15 cm from the lesion is generally advocated, along with removal of the corresponding thickened mesentery and enlarged lymph nodes. When the lesion is extensive, only the symptom-inducing lesion should be removed, while the lesion that does not cause symptoms should be left in the body to avoid the occurrence of short bowel syndrome due to excessive resection. Excessive resection of intestinal segments and enlargement of lymph node dissection cannot prevent recurrence, but affect the absorption of nutrients. After resection, end-to-end anastomosis is usually performed, and the anastomosis should be smooth and have good blood flow. In case of severe intestinal adhesions or abscess formation that cannot be resected, the diseased intestinal segment can be left open for shortcut diversion. If there is an abscess, it should be incised and drained, and the decision of whether to perform second-stage surgery should be based on the patient’s condition. Some reports suggest that resection of the appendix has a therapeutic effect on ileal Crohn’s disease. The opposite view is that simultaneous appendectomy predisposes to enterocutaneous fistula. No enterocutaneous fistula occurred in our group of patients who underwent appendectomy, and the author believes that appendectomy is safe for those without significant lesions in the ileocecal region. Surgical treatment is only one part of the comprehensive treatment of Crohn’s disease. Recurrence is an important feature of Crohn’s disease, and approximately 40% to 50% of patients require reoperation within 10 to 15 years after the first operation. Therefore, it is necessary to continue to strengthen nutritional support, choose effective antibiotics to control infection, and take immunosuppressants and other comprehensive treatment after surgery, which is expected to reduce the recurrence rate after surgery.