Ulcerative colitis (UC) is a chronic and debilitating disorder that is characterized by an inflammation of the colonic mucosa. The extra–intestinal manifestations of IBD, however, are not of less importance. In some cases, they are the first clinical manifestation of the disease and may precede the onset of gastrointestinal symptoms by many years. Cerebrovascular disorders are documented in 0.12% to 4% of IBD patients and apparently constitute the most extensively covered neurologic complication, as they play a very important role in disease morbidity. Physicians should be aware that patients with IBD and focal neurological deficits, even if they resolve automatically, are at an increased risk of stroke, independently of their age.