Pneumaturia is sometimes the first symptom of colovesical fistula. Colovesical fistula presents a difficult problem with complicated diagnosis and therapy. Most common are fistulas between the colon (sigmoid) and bladder, which results from sigmoiditis and diverticulitis. The paper reports the case of a 61-year-old man with diagnosis of diverticulitis and symptom of pneumaturia in duration of 3 months. The operation was successfully performed in cooperation with a surgeon and an urologist.