$re = '/(?s)#IF\s*false.*?#ENDIF|#IF\s*true\R(.+?)\R#ENDIF/m';
$str = '#IF false
If true the text should remain, else it should be deleted
#ENDIF
#IF true
If true the text should remain, else it should be deleted
#ENDIF
#IF false
If true the text should remain, else it should be deleted
#ENDIF
#IF true
If true the text should remain, else it should be deleted
#ENDIF
';
$subst = "$1";
$result = preg_replace($re, $subst, $str);
echo "The result of the substitution is ".$result;
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php