The present review deals with the elective and emergency management of colonic Crohn's disease (CD). Failed medical therapy is among the most common indications for the operative treatment. In case of fistula the operation is usually a resection of the diseased segment of colon with wedge or segmental excision and closure of the secondarily involved organ. The incidence of Crohn's colonic stricture ranges from 5% to 17%. The main indication for performing a total colectomy and ileoproctostomy in patients with extensive Crohn's colitis is to avoid a permanent ileostomy and preserve rectal function. The authors performed 60 laparoscopic procedures: 35 ileocolic resections, 10 total colectomies, 10 loop ileosigmoidectomies, and 1 proctectomy. In conclusion, the choice of operation depends on many factors, such as the site and extent of disease. In some select instances a segmental resection of CD may afford better function than an ileoproctostomy.