Diverticular disease is a common condition among the elderly, with a steady increase in prevalence over time. Also, it has a temporal, geographic, and ethnic variation in incidence and prevalence, the genetic component having only recently been studied. For many years, environmental factors were the main link to the etiology. Recent studies estimated the heritability in this disease and identified genetic variants associated with diverticulosis. The interaction between structural changes of the colonic wall, diet, lifestyle, and genetic factors results in the development of diverticular disease. The purpose of this article is to review the existing data about genetic influence in this disease.