New medical therapies that inhibit the bioactivity of TNF-alpha represent a major breakthrough in the treatment of Crohn's disease (CD). Anti-TNF-alpha, monoclonal, chimeric antibody (infliximab) is now FDA approved for use in patients with active CD. Other investigational drugs that also inhibit TNF-alpha activity include new 'humanised' anti-TNF-alpha antibodies (CDP571), thalidomide, new analogues of thalidomide, and TNF-alpha receptor fusion proteins. This review will summarise the key clinical data for each of these categories of TNF-alpha inhibition and discuss the potential economic impact of these new compounds on the cost of CD management.