Pediatric inflammatory bowel disease (PIBD), encompassing Crohn’s disease and ulcerative colitis, presents increasing diagnostic and therapeutic challenges. Delays in diagnosis and variability in treatment strategies can negatively impact disease progression and patient outcomes. To systematically review recent literature on PIBD, identifying diagnostic obstacles, examining current treatment modalities, and evaluating evidence-based approaches for selecting optimal first-line therapies. Nineteen studies published between 2017 and 2023 were reviewed, including narrative reviews, systematic reviews, consensus guidelines, and meta-analyses. The studies covered diverse populations across North and South America, Europe, Asia, and Oceania. Common themes included significant diagnostic delays due to nonspecific symptoms, underutilization of non-invasive biomarkers, and the critical role of early specialist referral. Emerging tools such as fecal calprotectin and genetic testing are aiding early detection. Treatment is shifting toward early biologic use, especially anti-TNF agents, in moderate to severe cases. Personalized care models, therapeutic drug monitoring, and multidisciplinary approaches have shown promise in improving disease control and long-term outcomes. System-level challenges—such as delayed drug approvals, insufficient transitional care, and limited pediatric trials—remain barriers to optimal care. Early diagnosis and individualized, evidence-based treatment strategies are essential for improving outcomes in children with IBD. Standardized protocols, access to biologics, and structured transition to adult care are critical. Continued research and global collaboration are needed to refine diagnostic tools, expand therapeutic access, and establish unified care standards for pediatric IBD. Let me know if you want...................... Keywords:............... Pediatric inflammatory bowel disease, Crohn’s disease, ulcerative colitis, diagnostic delay, biomarkers, biologic therapy, personalized medicine.