Dysbiosis disrupts the gut barrier in patients with inflammatory bowel disease (IBD), leading to activation of inflammatory responses. Fecal microbiota transplantation is a targeted microbiome-based therapy that may restores the gut health in IBD patients. In this presentation, Prof Kahn discusses the background and rationale for this innovative therapy. Several studies have demonstrated the efficacy and safety of Fecal microbiota transplantation in the management of recurrent/refractory Clostridium difficile infections. While fecal microbiota transplantantion may also benefit a select group of IBD patients, large robust clinical trials are required to systematically evaluate its therapeutic potential in this patient population. Fecal microbiota transplation for IBD raises significant issues and concerns. Prof Kahn also explores the logistical, ethical, social and regulatory issues associated with this therapy in this presentation.