Extraintestinal manifestations (EIMs) are common in inflammatory bowel disease (IBD) and can significantly impact disease management. The choice of treatment for EIMs depends on the specific manifestation, its severity, and the activity of the underlying IBD. Ocular manifestations, such as uveitis, scleritis, and episcleritis, often require tailored treatment approaches. Systemic corticosteroids, biologic agents, and topical medications are commonly used to manage these conditions. Hepatobiliary manifestations, including primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH), are often treated with anti-TNF agents, corticosteroids, or immunosuppressants. Musculoskeletal manifestations, such as axial and peripheral spondyloarthritis, are typically managed with anti-TNF agents or other biologic therapies. Nonsteroidal anti-inflammatory drugs (NSAIDs) should be used with caution due to the risk of exacerbating intestinal inflammation. Mucocutaneous manifestations, including pyoderma gangrenosum, erythema nodosum, Sweet's syndrome, and oral lesions, often respond to anti-TNF agents or other immunosuppressants. Treatment selection for EIMs requires a multidisciplinary approach involving gastroenterology, rheumatology, dermatology, and ophthalmology. The specific choice of treatment depends on patient factors, disease severity, and response to previous therapies.