The medical therapy of Crohn's disease has improved considerably in recent years. In large part, this is due to the introduction of new efficacious agents, both "biologics" and traditional small molecules. Further study of older drugs has also advanced our ability to devise the optimum approach to individual Crohn's disease patients by better clarifying the benefits, adverse effects, and means to optimize doses of established medications. In this review, we present an evidence-based approach to the medical management of active Crohn's disease, Crohn's disease in remission, and perianal Crohn's disease that emphasizes recent advances that have come from the results of randomized controlled clinical trials.