The Epimad registry was established in 1988 and covers four departments in northwestern France (Nord, Pas-de-Calais, Somme, and Seine-Maritime). It provided the first data on the incidence of inflammatory bowel disease (IBD) in France. This registry covers nearly 6 million people, representing 9.1% of the French population. The collection of cases relies on close collaboration between private, hospital-based, and university-affiliated gastroenterologists, including both adult and pediatric specialists. From 1988 to 2014 (the most recent validated year), 19,266 new cases were recorded with a definite or probable form of IBD. Private-practice gastroenterologists reported 80% of the cases. Over the period, the incidence of Crohn’s disease (CD) increased significantly from 5.3 to 7.6 per 100,000 inhabitants, while that of ulcerative colitis (UC) remained stable at 4.4 per 100,000 inhabitants. Since 2003 in particular, a sharp rise in the incidence of IBD among adolescents has been reported, increasing from 4.2 to 9.5 per 100,000 (+126%) for CD and from 1.6 to 4.1 per 100,000 (+156%) for UC. Spatial and temporal heterogeneity in IBD incidence was identified at the cantonal level, and four clusters with an increased risk of UC were identified. These data will enable the implementation of analytical epidemiological studies to identify potential environmental risk factors associated with IBD.