Diverticulosis is a disease of modern civilization. Complications may develop, the most common being acute diverticulitis. Repeated attacks, particularly those requiring hospitalization, strongly suggest the need for elective surgical resection of the involved colon. Young persons and patients who are immunocompromised require a particularly aggressive surgical approach. Elective resection is considerably safer than emergency operation. Defining which persons will benefit from surgical therapy is the goal to minimize the morbidity and mortality associated with this common colonic disorder.