Treatment with the chimeric monoclonal antibody (infliximab) is highly effective in refractory and fistulising Crohn's disease, nevertheless, infliximab resistance may occur. Authors report a 12-year-old boy with infliximab refractory luminal Crohn's disease including 3 active perianal fistulas. The patient was treated successfully with adalimumab, a fully human anti-tumor necrosis factor alpha monoclonal antibody. After 10 weeks of therapy, the previously high activity index returned to normal and the fistulas were closed. Quality of life using validated questionnaire improved significantly also. Adalimumab might be a suitable therapy even in pediatric Crohn's disease patients with infliximab resistance.