Vedolizumab (Entyvio™), a humanized monoclonal antibody α4β7 integrin-receptor antagonist with gut-selective effects, is a useful addition to the biological options available to treat adults with moderately to severely active ulcerative colitis (UC) or Crohn’s disease (CD) refractory to standard medications. In both the clinical trial and real-world settings, treatment with intravenous vedolizumab was associated with improvements in many disease-related clinical outcomes in patients with moderately to severely active UC or CD, regardless of whether patients were tumor necrosis factor (TNF)-antagonist naïve or had previously experienced TNF-antagonist failure. Beneficial effects were shown at 6 weeks (i.e. after the initial loading doses of vedolizumab at weeks 0 and 2), with the benefits being maintained with long-term maintenance therapy with vedolizumab every 4 or 8 weeks. Vedolizumab is well tolerated and has a favourable safety profile, and does not appear to increase the risk of serious or opportunistic infections or malignancies.