Objective Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn's disease (CD), has been seen as an emerging health problem in Nepal with urbanization and the adoption of a Western lifestyle. Our study aimed to determine the various demographic and phenotypic features of IBD in Nepal. Methods This prospective observational study was conducted at the Nepal Mediciti Hospital (Lalitpur, NPL), comprising IBD patients from 2017 to 2024. The demographic distribution of IBD was classified according to age, gender, and ethnicity, while the phenotypic distribution was done according to disease location and severity of the disease. Results Among 1015 IBD patients, 752 (74.1%) had UC and 263 (25.9%) had CD. The IBD was predominantly seen in males (60.7% vs 39.3 %). The mean age at diagnosis of IBD was 39.67 ± 14.53 years, 38.3 ± 8.4 years for UC, and 31.8 ± 6.7 years for CD. Inflammatory bowel disease was more common (51.1%) in the Khas-Arya race, followed by Newars (18.8%). The most common location of UC was left-sided (43.8%), and ileocolonic for CD (55.5%). The majority of the IBD patients presented in a state of moderate activity (UC 50.1% and CD 62.4%), followed by mild activity (UC 39.2% and CD 29.3%). Only a few IBD patients presented in severe form (UC 10.6% and CD 8.4%). Conclusion This study highlights the increasing burden of IBD in Nepal, affecting more men than women, occurring at the mean age of thirties, and mostly seen in the Khas-Arya race. We found mostly left-sided disease in UC patients, while ileocolonic disease was the most common phenotype in CD. The majority of IBD patients in our study presented with moderate activity. Further large-scale, long-term, multi-center studies are needed to provide a more comprehensive knowledge of the clinico-epidemiological evaluation of IBD in Nepal.