Optical enhancement technologies are emerging as promising tools to improve diagnosis and clinical management of patients with inflammatory bowel diseases (IBD). The use of dye-based and dye-less chromoendoscopy may improve either characterisation of mucosal inflammation or detection of dysplastic and early neoplastic lesions. Confocal laser endomicroscopy and endocytoscopy both allow for in vivo and real-time microscopic analysis of the tissue. Moreover, the newly introduced molecular imaging has now also become feasible for in vivo diagnosis in IBD. This review focuses on the more recent progresses of advanced endoscopic imaging techniques in the setting of IBD and provides the reader with an updated overview on accepted clinical evidence and ongoing fields of research.