Spondyloarthritis (SpA) is the most frequent extraintestinal manifestation in patients with inflammatory bowel diseases (IBD). When IBD and spondyloarthritis coexist, musculoskeletal and intestinal disease features should be considered when planning a therapeutic strategy. Treatment options for IBD and SpA have expanded enormously over the last few years, but randomized controlled trials with specific endpoints focused on SpA are not available in the IBD setting. To address this important clinical topic, the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) and the Italian Society of Rheumatology (SIR) jointly planned to draw updated therapeutic recommendations for IBD-associated SpA using a pseudo-Delphi method. This document presents the official recommendations of IG-IBD and SIR on the management of IBD-associated SpA in the form of 34 statements and 4 therapeutic algorithms. It is intended to be a reference guide for gastroenterologists and rheumatologists dealing with IBD-associated SpA., Competing Interests: Declaration of competing interest FSM served as an advisory board member and/or received lecture grants from AbbVie, Biogen, Lionhealth s.r.l., Ferring, Galapagos, Janssen, Pfizer, Samsung Bioepis, and Takeda Pharmaceuticals. FC served as consultant to: Abbvie, MSD, Takeda, Janssen, Roche, Celgene, Bristol-Meyers Squibb, Galapagos, Gilead, Pfizer, Mundipharma, Galapagos, Biogen, Ferring, Eli-Lilly, Nestlè, Lionhealth; received lecture fees from Abbvie, Ferring, Takeda, Allergy Therapeutics, Janssen, Pfizer, Biogen, Galapagos, Sandoz, Eli-Lilly; received unrestricted research grants from Giuliani, Sofar, MSD, Takeda, Abbvie, Celltrion, Pfizer, Actial. CB served as consultant for Takeda, MSD, Ferring, Galapagos, Pfizer, Janssen and AbbVie. RC served as speaker and received consultant fee from Abbvie, Lilly, Galapagos, Pfizer, MSD, Janssen, UCB, Novartis, Fresenius, Accord. FC received research support from AbbVie, Eli Lilly, Novartis, Pfizer; Consulting and speaking fees from AbbVie, Astra Zeneca, Bristol-Myers Squibb, Eli Lilly, Galapagos, Janssen, Novartis, Pfizer, and UCB. SDA: consulting and speaking fees from AbbVie, Amgen, Bristol-Myers Squibb, Janssen, Lilly, MSD Italy, Novartis, Pfizer and UCB. MCF has acted as a consultant for: AbbVie, Celgene, Celltrion, Gilead, Pfizer, MSD, Bristol-Meyer, Takeda, Janssen-Cilag, Eli-Lilly, Roche, Galapagos, Biogen; he has received financial support for research from Janssen-Cilag, Pfizer. SF: consultancy fees and/or Advisory member for Takeda, Galapagos, Abbvie, Pfizer, Janssen-Cilag. FI received honoraria or consulting fees from Abbvie, Eli-Lilly, Galapagos, Janssen, and Pfizer. CP has received consultancy fees and educational grants from Galapagos Pfizer, Janssen-Cilag Takeda, Chiesi, Sofar, Sandoz, Zambon. GP: research grants, consultation, and/or speaking from Abbvie, Alfasigma, Amgen, BMS, Fresenius Kabi, Galapagos, GSK, Lilly, Pfizer, UC. DP: speaker's fee/advisory board from Janssen, Pfizer, Galapagos, Takeda, MSD, AbbVie, Biogen. AR: advisory board and consultant for Abbvie, Takeda, Janssen, MSD, Pfizer, Sandoz, Galapagos. SS: consultancy, lecture fees, and advisory board for AbbVie, Arena, Ferring, Galapagos, Gilead, Janssen, MSD, Pfizer, and Takeda. AV: lecture fees from Abbvie, Janssen-Cilag, Takeda, Pfizer, Zambon, Lionhealth; consultant for Abbvie, Janssen-Cilag, Takeda, Pfizer, Ferring, Celltrion. AA: consulting/advisory board fees from AbbVie, Amgen, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, Lionhealth, MSD, Mylan, Nestlé, Pfizer, Protagonist Therapeutics, Roche, Samsung Bioepis, Sandoz, Takeda, Tillots Pharma; speaker's fees from AbbVie, Amgen, Biogen, Bristol-Myers Squibb, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Novartis, Pfizer, Roche, Samsung Bioepis, Sandoz, Takeda, Tigenix; research grants from MSD, Takeda, Pfizer, Biogen. AO served as an advisory board member for AbbVie, Ferring, Galapagos, MSD, Janssen, Pfizer, Takeda Pharmaceuticals, and received lecture grants from AbbVie, Ferring, Lionhealth s.r.l., MSD, Sofar, Chiesi, Janssen, Pfizer, and Takeda Pharmaceuticals. LB, AC, MSC, EL, PM, CS, MZ have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)