Objective: To explore the value of combined detection of fecal calprotectin (FC), lactoferrin (LF), and intestinal microbiota metabolites in assessing the activity and predicting recurrence of inflammatory bowel disease. Methods: A total of 100 cases of inflammatory bowel disease admitted between May 2021 and May 2024 were selected and divided into remission group (n=25) and active group (n=75). The expression levels of FC, LF and intestinal microbiota metabolites were compared, and the expression levels of these indexes were compared among patients with different activity degrees in active group to evaluate the diagnostic value and analyze their correlation with disease activity. After 12 months of follow-up, patients were divided into recurrence group and non-recurrence group to compare general data and expression levels of FC, LF and intestinal microbiota metabolites, and analyze the influencing factors of recurrence. Results: The activity group showed higher FC, LF, primary bile acid and H?S than the remission group, while the total SCFAs was lower than that of the remission group (P<0.05); There were differences in FC, LF, total SCFAs, primary bile acid and H?S among patients with different activity levels (P<0.05); ROC curve analysis showed that FC, LF, total SCFAs, primary bile acid and H?S combined were more valuable than a single index for the diagnosis of active inflammatory bowel disease; The Spearman correlation analysis showed that FC, LF, primary bile acid and H?S were positively correlated with the activity degree of inflammatory bowel disease, while the total amount of SCFAs was negatively correlated with the activity degree of inflammatory bowel disease (P <0.05); There were differences in disease severity, FC, LF, total SCFAs, primary bile acid and H?S expression levels between the recurrence group and non-recurrence group (P <0.05); The multivariate logistic regression analysis showed that the aggravation of disease severity, FC, LF, primary bile acid and increased H?S levels were risk factors, while the increase of total SCFAs was a protective factor (P<0.05). Conclusion: With the aggravation of inflammatory bowel disease, FC, LF, primary bile acid and H?S increased, and the total amount of SCFAs decreased. The combined detection of fecal FC, LF and intestinal flora metabolites can effectively evaluate the activity of inflammatory bowel disease, and the above indicators can be used to early warn the risk of recurrence of patients..