Treatment of Crohn’s disease (CD) is complex and based on differentdrugs. The biological treatments act on different stages of immunophysiopathologicalprocesses of the disease to change the evolution ornatural history. The targets of these therapies, most of which are still experimental,and still off label in pediatrics, are highly selective and includeproinflammatory cytokines, the CD4 positive T cells, the Th1 and Th2 subgroupsand adhesion molecules. At present monoclonal antibodiesagainst TNF-α studied and/or used for Crohn’s disease are four: a chimericalone (Infliximab), a 95% humanized one (CDP 571), a humanized andpegylated one (Certolizumab pegol) and finally a fully humanized type(Adalimumab). On the contrary, have been considered TNF-α recombinantreceptors (Etanercept and Onercept) that have proven be ineffective forthe treatment of active CD. The paediatric Crohn’s is an early onset formof disease, that much better takes advantage of biological therapy comparedwith late onset adulthood forms.