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Abstract: Background: Growing evidence recognizes inflammatory bowel disease (IBD) as a chronic inflammatory condition characterized by a hypercoagulable state and prothrombotic conditions. The aims of our study were to evaluate the abnormalities in coagulation and fibrinolysis status in patients with IBD, and to analyze parameters of altered coagulation and fibrinolysis status which can correlated with and predict inflammatory parameters of disease activity. Methods: A cohort of 271 consecutive IBD patients was compared with healthy controls for coagulation and fibrinolysis status. Associations between altered coagulation and fibrinolysis status stratified by gender and inflammatory parameters were analyzed. Results: The mean levels of platelet, platelet distribution width, prothrombin time, fibrinogen, activated partial thromboplastin time were significantly higher in IBD patients than in healthy controls (all P <0.05). Mean platelet volume was lower in male patients with IBD than in healthy controls (P <0.01). Furthermore, multiple linear regression indicated that fibrinogen was an independent predictor of ESR (β=1.316, P =<0.001) and CRP (β=1.233, P =0.015) in male patients with active ulcerative colitis. Platelet (β=0.436, P =0.037) and prothrombin time (β=0.810, P =<0.001) were predictors of Crohn''s Disease Activity Index in female patients with Crohn''s disease. Conclusions: To our knowledge, this study provides characteristics on altered coagulation and fibrinolysis status in active IBD patients using the largest number of cases assembled in one study to date. Our data suggest that in IBD patients, abnormalities in coagulation and fibrinolysis status were associated with disease activity. Fibrinogen, platelet and prothrombin time were predictors of inflammation. [Copyright &y& Elsevier]