The management of patients with inflammatory bowel diseases (IBD) has been evolving with the development of new therapies. Therapeutic targets have shifted from clinical remission to endoscopic remission. Even though, short and long-term complications such as fecal incontinency, disability, hospitalization, need for surgery, and colorectal cancer is still seen among patients. In order to prevent these complications, the concept of disease clearance has been proposed for both ulcerative colitis and Crohn’s disease. It consists of clinical, endoscopic, and histologic remission for patients with ulcerative colitis and also transmural healing for those with Crohn’s disease. Clinical trials on patients with ulcerative colitis have shown that the treat-to-clear strategy is possible, but rates are low. Patients who have achieved disease clearance were associated with a significantly lower risk of relapse and better disease outcomes. Treat-to-clear is readily applicable to patients with ulcerative colitis, where the extent of disease can be evaluated by colonoscopy and histology can be easily used. Also, fecal calprotectin levels have a good accuracy for histologic healing. The patchy distribution of Crohn’s disease precludes histologic evaluation in many cases and biochemical inflammatory markers are less sensitive. Cross-sectional imaging and bowel ultrasound have become the methods of choice for detecting transmural healing. Treat-to-clear is achievable, measurable, and is associated with long-term benefits and improved outcomes in patients with Crohn’s. Histology and less invasive measures such as bowel ultrasound and magnetic resonant enterography are being validated and are becoming new targets in disease monitoring. Disease clearance is achievable by raising the bar in terms of treatment strategies which leads to the need for switch or swap therapy, but it can impose higher costs and an increase in the risk of adverse side effects. Today, many clinicians continue a treat-to-target strategy and only few target mucosal healing as the ultimate goal in ulcerative colitis. This remains to be our main challenge in the upcoming decade. We believe that the treat-to-clear strategy is the future for IBD-dedicated clinicians. This strategy needs to be defined for ulcerative colitis and Crohn’s disease, separately. Integrating biochemical and molecular data and also bowel ultrasound will lead to a personalized approach in treating IBD patients in the near future.