The first meeting dedicated to intestinal fibrosis, entitled The First International Summit on Fibrosis in Intestinal Inflammation: Mechanisms and Biological Therapies, was held in Cleveland, Ohio, USA, on 28-29 September 2010. Intestinal fibrosis is a complication of inflammatory conditions affecting the small and large bowel and often results in serious clinical consequences. Despite its clinical importance, the study of inflammation-driven intestinal fibrosis has received very limited attention. This explains why so little is known about its pathophysiology and the lack of significant therapeutic advances, in contrast with the recent success achieved in controlling gut inflammation with biological agents. The meeting covered most aspects directly relevant to intestinal fibrosis, including gut inflammation; cellular and molecular mechanisms of intestinal fibrogenesis; new clinical, diagnostic and prognostic tests and novel therapeutic approaches.