BACKGROUND: The course of Crohn’s disease often leads to complications requiring surgical treatment. One of the most serious complications of Crohn’s disease is intestinal bleeding. AIM: To determine the most optimal timing and extent of surgical treatment in patients with Crohn’s disease complicated by intestinal bleeding when conservative therapy is ineffective. MATERIALS AND METHODS: The article presents the experience of treating patients with Crohn’s disease complicated by intestinal bleeding at the Center for Gastroenterology and Oncopreventology of the Elizabeth Hospital (Russia) and the Republican Scientific Center of Coloproctology (Uzbekistan). RESULTS: Despite the possibilities of conservative treatment, in 33% of cases the therapy was ineffective and required urgent surgical intervention. The degree of intervention was selected individually based on multivariate analysis. CONCLUSIONS: Intestinal bleeding is a life-threatening complication of Crohn’s disease, causing the need for surgical intervention in almost a third of cases. Crohn’s disease is characterized by various damage to the gastrointestinal tract, which require multiple options for resective surgery on the small and large intestines, as well as an individual approach to the degree of intervention. The use of modern methods of complex conservative therapy for Crohn’s disease can reduce the risk of complications and reduce the amount of surgical intervention.