Pouchitis is a common complication that develops after an ileal pouch-anal anastomosis after colectomy for ulcerative colitis. In some cases, pouchitis becomes chronic and refractory to conventional therapies including antibiotics, corticosteroids, immunomodulators, probiotics, and anti-inflammatory drugs. We report a case of an adolescent with chronic pouchitis who not only improved with infliximab therapy but remains in long-term remission with maintenance therapy without any adverse effects. Infliximab is a safe and effective therapy for refractory pouchitis and may obviate the need for pouch removal and a permanent ileostomy.