We reviewed our experience with same hospitalization resection in the treatment of acute diverticulitis (AD) and compared outcomes with patients admitted for elective resection. From January 1987 through December 1996, 20 patients (Group 1) were admitted with AD and were operated on during the same hospital admission. During that same time period, 22 patients (Group 2) were admitted for elective resection and found to have an abscess intraoperatively. Thirty patients had elective resection with no abscess found (Group 3), and 10 patients were found to have a fistula to adjacent structures during elective resection (Group 4). Demographics and type of procedure done were similar in all groups. Fifteen patients (75%) in Group 1 had an abscess; eight were pericolic, and seven were pelvic. In contrast, all Group 2 abscesses were pericolic (P < 0.001). There was no mortality or major morbidity in any group. Patients in Groups 1 and 4 had higher fluid requirements (not significant), estimated blood loss (P < 0.01), and longer operative times (P < 0.05) when compared with the other groups. Postoperative and total hospital stay was significantly longer in Group 1. We conclude that hospitalized patients with AD who meet indications for surgery can be operated on during the same hospitalization without an increase in morbidity, compared with those patients discharged and later readmitted for elective resection.