Abstract:Objective To summarize the clinical and endoscopic features of 23 patients with intestinal Behcet's disease(BD). Methods The general data,clinical features, endoscopic findings, laboratory tests, surgical therapy and outcomes of 23 intestinal BD patients administered in Drum Tower Hospital affiliated to Nanjing University from January 2016 to March 2021 were analyzed retrospectively. Results Out of 23 intestinal BD, there were 15 males and 8 females with the age of onset (32.0±12.2) years old. In addition to oral ulcers, skin lesions and vulvar ulcers were common clinical manifestations, and abdominal pain, diarrhea and bleeding were more common in gastrointestinal manifestations. The ileocecal region was involved in 22 cases (95.7%).The classic volcano-like ulcers showed in 12 cases (52.2%)， all of which involved the ileocecal region, including 8 cases of local single ulcer and 4 cases of local multiple ulcers.Non-volcano-like ulcers showed local single, local multiple and ≥3 intestinal segments. Of 12 patients with volcano-like ulcers,5 had received surgical therapy. Endoscopy were reconducted in 12 patients，7 of 7 patients on biological therapies and 3 of 5 patients on steroid combined immunosuppressants (IMMs)had endoscopic improvement or mucosal healing. Conclusion Intestinal BD involves the ileocecal region most frequently, local single or multiple. Volcano-like ulcers, round punched-out ulcers and geographic-shaped ulcers were all typical ulceration. Volcano-shaped ulcers responded poorly to traditional steroids-IMMs therapy, when diagnosis is made, actively upgrading the therapy to biological agents is well recommend.