Abstract Objectives To investigate the concordance of medical care of ulcerative colitis (UC) patients in Italy. Methods Interviews with responsible physicians in referral centres for inflammatory bowel disease (IBD) regarding the management (e.g. time to referral, time to diagnosis, disease activity at the first visit and after 1 year, treatment algorithm, treatment goals, follow up, etc) of patients with UC. Results The obtained data showed a correct diagnostic approach, once the patient reached the referral centre, and similar figures for disease activity as reported in studies on epidemiology or on the natural history of UC. Treatment goals for the acute phase of disease and for maintenance therapy were mainly clinically oriented and include only in a minority parameters like quality of life or the regulation of the immune response. Conclusions The treatment algorithms were consistent with the established guidelines for the treatment of UC. Major disparity was found for the endoscopic control of treatment success.