Among inflammatory bowel diseases (IBDs), every tenth develops during childhood, which is characterized by a more complex disease course, more extensive spread, and rapid progression. The presenting symptoms of pediatric-onset IBD are often nonspecific, and diagnostic delays increase the risk of intestinal damage, bowel resection, and growth retardation. Adolescents with IBD exhibit the lowest compliance and medication adherence rates, contributing to the frequent occurrence of complications. The most significant extraintestinal complications in pediatric-onset IBD patients include growth retardation, malnutrition, impaired bone metabolism, malignancies, and opportunistic infections. In this patient group, surgical interventions are required earlier and more frequently, and the hospitalization rate is also higher among them. Ensuring optimal disease progression and quality of life is crucial, making it essential for the physicians managing their care to be well aware of the specific characteristics of the pediatric-onset IBD patient group.