Background Inflammatory bowel disease (IBD) is an inflammatory disorder associated with significant morbidity and mortality. Recent studies have reported sarcopenia as a significant factor affecting the quality of life and outcomes of these patients. Methods We used the National Inpatient Sample 2016–2020 to identify adult patients with IBD. The patients were stratified into two groups based on the presence of sarcopenia. Data were collected on patient demographics, hospital characteristics, and comorbidities. The outcomes studied were in-hospital mortality, sepsis, shock, ICU admission, and need for surgery. Multivariate logistic regression analysis was performed. Results A total of 1 524 820 IBD hospitalizations were included. Of these, 209 615 (9%) were noted to have sarcopenia. Patients with sarcopenia had a higher incidence of in-hospital mortality (4.2% vs. 1.2%, P < 0.001), ICU admission (6.5% vs. 2.4%, P < 0.001), and need for abdominal surgery (6.5% vs. 3.5%, P < 0.001). After adjusting for confounders, the presence of sarcopenia was associated with higher odds of in-hospital mortality (adjusted odds ratio: 2.83, 95% confidence interval: 2.66–3.02, P < 0.001) and additional worse outcomes. Conclusion Our study reports that the presence of sarcopenia was associated with an increased risk of death and the need for abdominal surgery. Preventative measures aimed at improving sarcopenia should be taken to prevent worse outcomes in this patient population.