Introduction: Crohn’s disease can often be complicated by intra-abdominal abscesses. Mild cases are managed with percutaneous drainage and antibiotics while severe cases require surgical management. While resumption of biologic therapy is often delayed post operatively due to concerns for infections and poor wound healing, early resumption in high-risk patients has been associated with lower rates of early disease recurrence. Early initiation of post-operative Vedolizumab, a newer anti-integrin biologic, has not been well documented in the literature. Case description/methods: A 28-year-old man with a 7-year history of Crohn’s disease currently managed with vedolizumab and budesonide, presented with one-week history of worsening left lower abdomen and groin pain. Work-up revealed body mass index of 16, hemoglobin 3.6 g/dL, and CT imaging showing a multi-loculated abscess involving the left iliopsoas muscle with tract formation towards the descending colon. He was started on piperacillin-tazobactam and underwent percutaneous drainage of abscess. Repeat CT demonstrated re-accumulation of abscess despite drainage and antibiotics. A subtotal colectomy was performed with ileostomy formation and I&D of the abscess. The patient was continued on antibiotics, and he received his first dose of vedolizumab inpatient on post-operative day 7 given his severe presentation. At his 1 and 3 month follow up in clinic he was noted to have pink and healthy ileostomy stump, well healing incisions, and no signs of infection. He was also tolerating his diet well with more formed stools from his ostomy and a 20-pound weight gain since discharge. Discussion: Crohn’s patients have a high lifetime risk of requiring surgical management of disease. There is a 90% risk for post-operative endoscopic recurrence (PER) at 12 months in these patients. While resumption of biologic therapy has been shown to reduce rates of PER at 6 and 12 months, early initiation of therapy, especially in patients with ileostomy formation, has been controversial given concerns for infections and poor wound healing. Outcomes of early resumption with Vedolizumab in particular, has not been well reported. We present the case of a high-risk patient with active infection who restarted therapy within 7 days of resection with good surgical outcomes and no clinical recurrence at 3 month follow up. Early initiation of Vedolizumab may prove to be a viable strategy in preventing early PER and repeat surgery.