Background and Aims. Use of anti-TNF therapies varies internationally. As an initiative of the international Pediatric IBD Network (PIBDNet), we compared global pediatric IBD anti-TNF practice patterns. Methods. Physicians were surveyed about anti-TNF use in Crohn’s disease (CD) and ulcerative colitis (UC). Chi-squared, independent samples Mann–Whitney U, or related samples Wilcoxon signed rank tests were used to compare groups. Results. 344 physicians treating pediatric IBD responded from 43 countries (54% North America, 29% Europe, 6% Oceania, 6% Asia, 3% Africa, and 2% South America). Respondents treated a median 40 IBD patients. CD was more commonly treated with anti-TNF than UC (40% vs. 10%, p