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Background and aim: Inflammatory bowel disease (IBD) prevalence has increased and a North–South gradient has been reported. We estimated the nationwide prevalence of IBD, ulcerative colitis (UC) and Crohn's disease (CD) in 1993, and prevalence of IBD in 2008, and assessed the geographical distribution of IBD in Finland. In addition, we investigated the vitamin D levels in a study population from a large, nationally representative health examination survey, the Health 2000 Survey.Methods: The register study for prevalences included all patients who had special reimbursement of medications for IBD in the years 1993 (n = 10,958) and 2008 (31,703). The study for D-vitamin measurement consisted of 6134 persons who had participated in the Health 2000 Survey.Results: The nationwide point prevalence of IBD in 1993 was 216 per 100,000 inhabitants, and 595 in 2008. In 1993, the prevalence of UC (177) was fourfold higher than the prevalence of CD (38). The prevalence of IBD and UC in Finland increased from South to North. For CD, no geographical variation could be demonstrated. In the Health 2000 survey, vitamin D levels were lower in Northern than in Southern Finland.Conclusions: Finland belongs to high prevalence area of IBD and this prevalence has increased nearly threefold during the past 15 years. A clear North–South gradient has been shown for IBD and UC, but not for CD. Slightly lower vitamin D levels in Northern Finland may be associated with the observed higher prevalence of IBD there.