The author presents an overview and critical analysis of the most important papers concentrated on efficacy and safety of methotrexate therapy in patients with inflammatory bowel disease. Non-controlled and rando- mized double blind studies published during last ten years were analyzed. With regard to clinical studies and limited personal experience the author considered methotrexate therapy as a part of standard medicamentous therapy in patients with drug refractory Crohn’s disease. The most suitable patients for methotrexate therapy are young with the fistulasing type of Crohn’s disease without a therapeutic effect of corticosteroids, immuno- supressive drugs and antibiotics. Methotrexate therapy should be started in tertiary medical centres with careful monitoring of side-effects.

        Key words: Crohn’s disease – methotrexate – immunosupressive drug – inflammatory bowel disease