Background: previous studies have evaluated the ability of biological markers to detect disease relapse in Crohn’s disease (CD). However, no studies investigated the role of C-reactive protein (CRP) levels as a prognostic factor to predict recurrence and degree of recurrence after surgical resection.Aim: to explore whether C-reactive protein (CRP) is a valid marker to predict an early recurrence following ileo-cecal (I-C) resection in CD.Methods: Thirty-nine consecutive CD patients undergoing laparoscopic or open I-C resection for CD in our Unit were enrolled in this prospective longitudinal study . CRP levels were measured pre-operatively, 48 hours after surgery and at discharge. As control group, 20 patients undergoing right colectomies for cancer in our Unit during the same period were evaluated. CRP was measured using the same intervals as in CD patients. Small intestine contrast ultra-sonography (SICUS) was performed to detect early recurrence at 6 month after surgery. Rutgeerts' score (grade 0-4; recurrence score <=1) was assessed at 1 year with conventional colonoscopy. Statistical analysis included the Fisher exact test ( 2 tails) for qualitative variables, the Student’s t test for quantitative variables and regression analysis for coefficient of correlation. Results: twenty-two patients undergoing a protocol of study searching for recurrence at 6 month using the SICUS were assessed. Findings compatible with recurrence at the anastomotic site (bowel wall thickness <=3 mm) were observed in 15 cases (68%). Normal CRP levels ad discharge were observed in 2 out of the 7 patients showing no sonographic findings of recurrence. All 15 CD patients undergoing colonoscopy at 12 months showed recurrence. No significant correlation was observed between endoscopic degree of recurrence and the 3 given measurement of serum CRP levels, also when the difference between each time determination in each patient was considered for the analysis. In the control group the median CRP values were higher 48 hours after surgery than at discharge and, as expected, both levels were higher in the CD group than in the controls (67.1 mg; p=0.02 vs 21 mg; p=0.04). conclusion: sicus and endoscopic recurrence after i-c resection in cd patients, do not seems to correlate with a high crp level at discharge. at the present, serum crp levels in the peri-operative period do not represent a useful marker for predicting the degree of endoscopic recurrence 1 year after ileo-colonic resection.