Abstract Background Inflammatory Bowel Disease (IBD) is associated with extraintestinal manifestations (EIMs), commonly affecting the joints, eyes, skin, and liver, and influences treatment selection. We aimed to synthesize evidence from systematic reviews (SRs) with or without meta-analyses on the efficacy of therapeutic options for rheumatological EIMs to better clarify their positioning in the management of IBD Methods We searched MEDLINE, Embase, and the Cochrane Database of Systematic inception to May 31 2024 to identify SRs addressing therapeutic interventions for rheumatological EIMs. The exclusion criteria ruled out studies that were not SRs, did not focus on patients with IBD patients, or were unrelated to articular interventions. Screening, selection, and data extraction were performed independently by two authors, with a third author consulted when necessary. Reporting was aligned with PRISMA standards. The quality of SRs was assessed using the AMSTAR-2 tool Results We screened 1,436 references and included 10 SRs (2 with meta-analyses) in our analysis. The rheumatological EIMs most commonly reported included arthralgia, peripheral arthropathy, axial arthropathy, spondyloarthritis, and sacroiliitis. Therapeutic interventions included in the SRs were anti-TNF agents, methotrexate (MTX), ustekinumab, (UST) vedolizumab (VDZ), and JAK inhibitors. Treatment efficacy was mainly reported through symptom reduction rates. Quality of the SRs rated from high to very low confidence, with most achieving moderate confidence due to some non-critical weaknesses. In four SRs anti-TNF therapy showed high response rates for both axial (range 59.1% to 61.8% in a SR) and peripheral spondyloarthritis (range 73.4% to 81.2% in a SR). One SR reported MTX as effective for peripheral enteropathic arthritis. Data on VDZ, UST, and JAK inhibitors were more controversial. One SR reported that UST was effective for arthralgia and psoriatic arthritis. A more recent meta-analysis showed that the improvement of pre-existing joint manifestations was greater in UST-treated patients compared to VDZ-treated patients (54% vs 42%). For tofacitinib, no change in peripheral arthritis was reported by two SRs. Four SRs evaluated treatment-induced rheumatological EIMs, revealing heterogeneous results, particularly with VDZ. However, data from a recent SRs suggest similar rates of new-onset rheumatological EIMs with VDZ and UST (9% vs. 6%) Conclusion Anti-TNF therapy appears to be effective in managing both peripheral and axial spondyloarthritis. Given the lack of consistent data on new advanced therapies, prospective studies designed to assess the impact of other advances therapeutics on rheumatological EIMs ,with rigorous endpoint assessment, are needed