Chronic inflammatory disorders such as Inflammatory Bowel Disease have a considerable effect on the metabolism of bone and are generally associated with Bone Mineral Disease (BMD). In children and adolescents, it is of particular importance because not only does it increase the risk of fracture but it has a deleterious effect on overall bone growth, development and peak bone mass. The mechanisms contributing to bone abnormalities are multifactorial, however the most important is inflammatory cytokines found in high amounts in inflammatory diseases, the use of corticosteroids for treatment of IBD, lack of proper nutritional status and a delay in puberty in active disease. All mechanisms are correlated with one another, so there is difficulty in pinpointing what the real culprit behind the skeletal abnormalities is. Current diagnostic methods consist of several radiating and non-radiating and laboratory techniques, the most widely used and available of which is the DXA scan. Measurements from DXA scan are correlated to Z-scores that are standardized based on age and gender. With proper z-score measurment we can attempt to properly treat children and adolescents with pediatric-onset IBD before they reach their peak bone mass. Nutritional interventions such as dietary Vitamin D and Calcium supplementation, even though are widely used, are not shown yet of substantial efficacy in patients with IBD. With understanding the mechanisms of BMD in Ulcerative Colitis and Crohn's Disease, it is crucial to focus on the development of targeted therapies that work to maximize growth yet limit disease activity in children with IBD.