Background: Inflammatory bowel disease (IBD) is a chronic inflammatory condition that affects the gastrointestinal tract. This group of disorders includes Crohn's disease and ulcerative colitis. Diagnosis of IBD involves a comprehensive approach that combines medical history, physical examination, laboratory tests, endoscopy, imaging, and occasionally biopsy of intestinal tissue. Patients with IBD have an increased risk of developing colorectal adenocarcinoma, a type of colorectal cancer. However, IBD induced by surgical resections of the intestines or chemotherapy drugs is extremely rare. Objective: This study aimed to throw the light on the importance of careful evaluation and accurate diagnosis in patients presenting with symptoms suggestive of both types of IBD.  Subject and methods: This abstract presents a challenging case in which a patient was initially suspected to have chemotherapy-induced colitis but was ultimately diagnosed with IBD-associated colorectal cancer. Results: The case highlighted the importance of careful evaluation and accurate diagnosis in patients presenting with symptoms suggestive of both IBD, as the treatment approaches and prognoses can significantly differ between the two conditions. Conclusion: Capecitabine, commonly used in cancer treatment, can induce colitis with symptoms that overlap with those of inflammatory bowel disease (IBD). Distinguishing between capecitabine-induced colitis and IBD is challenging due to similar clinical presentations. Discontinuation of capecitabine often leads to symptom improvement, but in IBD cases, additional therapies like steroids and biologics may be necessary. Close monitoring and further evaluation are crucial for accurate diagnosis and appropriate treatment strategies in patients experiencing gastrointestinal toxicity from capecitabine-based chemotherapy.