INTRODUCTION: Inflammatory bowel disease (IBD) is a non-specific chronic inflammatory disease. Previous studies confirmed that inflammation plays an important role and red blood cell distribution width (RDW) is related to the activity of IBD. OBJECTIVES: To identify the prognosis value of RDW in the intestinal resection of IBD. PATIENTS AND METHODS: A total of 366 patients were included in this retrospective analysis, diagnosed with IBD between March 2012 and November 2014 in the Sixth Affiliated Hospital of Sun Yat-Sen University. All participants were followed up at least 5years. Patients’ demographic characteristics and laboratory data were obtained from medical record within 24h at first hospitalization. We compared the clinical features in the intestinal resection and non-intestinal resection groups. Kaplan–Meier estimates of the probability of intestinal resection post-admission time were computed, and compared with log-rank test according to stratification of RDW value. RESULTS: There were 93 patients in the intestinal resection group and 273 in the non- intestinal resection group. Significant higher RDW values were detected in the intestinal resection group (P<0.001). RDW was obviously related to indicators such as C-reactive protein (p=0.008). Univariate Cox regression analysis demonstrated that IBD type (Crohn’s disease or ulcerative colitis) (P<0.001), RDW (P<0.001), C-reactive protein (P<0.001) and others were associated with intestinal resection probability. But only RDW [OR: 1.088 (95% CI 1.009-1.173), P=0.03] and IBD type (P=0.001) were independent predictors. CONCLUSIONS: RDW and IBD type were independent predictors of intestinal resection in IBD. KEY WORDS: inflammatory bowel disease, intestinal resection, red blood cell distribution width