It is really a challenge to respond to the request to share my knowledge and experience about such an apparently simple and common topic as treating diverticulitis. However, to be sincere, this is a tremendously controversial issue. The controversy begins with the name diverticular disease. After 60 years (1), can we really call a condition that affects 50% to 60% of the people an illness? Nevertheless, it is very common that a patient who undergoes a routine test such as a CAT scan or colonoscopy is erroneously diagnostica-lly labeled as having uncomplicated diverticular disease.Most postulates are born from consensus, rather than from the large amounts of highly reliable evidence that we would like to see. In fact, they are not even the products of panels of experts. More than this, we have inherited paradigms regarding this entity that are still believed and practiced. For example, after two episodes of diverticular disease a patient is referred for surgery. “I am going to operate to avoid the necessity of a colos-tomy in the future.” (This is a phrase which confirms any patient’s worst fears.) Another example is the notion that every young patient with diverticulitis must undergo surgery. And, to be precise, there is a balance which the clinician or surgeon can bend at a whim, when will the majority of patients who end up having colostomies have them? After the second episode? The third? Or maybe the fourth? What is it that we want to prevent?If the patient is elderly, this could be a criterion for surgery. Being in good health is better for elective surgery, but if the high perioperative risks are taken into account, maybe surgery is not the best option. Who should tip this delicate balance one way or the other?In this piece I want to touch upon themes which continue to be controversial, which should be will known to all of those who have to manage this pathology.The simple fact of finding diverticula in an examination is called DIVERTICULOSIS (2). As everyone knows, diverticula must be present in the entire colon, but especially in the left colon. In Latin America the process which proceeds from inflammation through microperforations and onto the formation of masses of hardened fibrotic tissue with focal abscesses occurs almost exclusively in the sigmoid colon. Bleeding, the second field of interest, can occur in any part of the colon where there are diverticula. The most classical texts speak of diverticula in the right colon being more prone to bleeding than those in other areas (3). For some not very clear reason, patients who have episodes of inflammation tend to become inflamed again later, while those with a history of lower digestive hemorrhaging tend to have recurrent bleeding rather than inflammation.