Multiple studies confirm complementary and alternative medicine (CAM), or integrative therapy use is common among children with IBD. Pediatric prevalence rates are compatible with or exceed CAM use in adult IBD. Surveys indicate that biologically based therapies are the most frequently utilized modality among the pediatric IBD population. Concurrent use of biologically based CAM, such as herbals and supplements, and prescription medication is common and may cause untoward drug interactions. In this chapter, we review the available evidence for the safety and efficacy of the most commonly used biologically based therapies in IBD. Clinicians ought to appreciate the prevalence of CAM utilization in the pediatric IBD population, parent’s receptivity toward these modalities as adjuvant therapies, and the reticence to disclose utilization. We suggest that the maintenance of a cursory level of understanding and awareness of CAM modalities, including knowledge of efficacy, interactions, and contraindications, are essential to ensure patient safety.