Ulcerative colitis is a chronic inflammatory disease affecting the colon, characterized by mucosal inflammation starting in the rectum and extending proximally. The incidence and prevalence of ulcerative colitis are increasing worldwide, with higher rates in northern Europe, Canada, and Australia. Genetic predisposition, epithelial barrier defects, dysregulated immune responses, and environmental factors contribute to its pathogenesis. Patients typically present with bloody diarrhea and are diagnosed through colonoscopy and histological findings. Management aims to induce and maintain remission, using treatments such as 5-aminosalicylic acid drugs, steroids, and immunosuppressants. Colectomy may be necessary for medically refractory disease or to treat colonic neoplasia. The therapeutic options are expanding, with new drugs targeting different pathways. Ulcerative colitis can lead to severe complications, including colorectal cancer, and requires regular surveillance and long-term management.Ulcerative colitis is a chronic inflammatory disease affecting the colon, characterized by mucosal inflammation starting in the rectum and extending proximally. The incidence and prevalence of ulcerative colitis are increasing worldwide, with higher rates in northern Europe, Canada, and Australia. Genetic predisposition, epithelial barrier defects, dysregulated immune responses, and environmental factors contribute to its pathogenesis. Patients typically present with bloody diarrhea and are diagnosed through colonoscopy and histological findings. Management aims to induce and maintain remission, using treatments such as 5-aminosalicylic acid drugs, steroids, and immunosuppressants. Colectomy may be necessary for medically refractory disease or to treat colonic neoplasia. The therapeutic options are expanding, with new drugs targeting different pathways. Ulcerative colitis can lead to severe complications, including colorectal cancer, and requires regular surveillance and long-term management.