SummaryRecent advances in our understanding of the pathogenesis of diverticular disease of the colon demand a more critical approach to the pathologic, radiologic and clinical distinction between diverticulosis and diverticulitis. In evaluating the rationale and efficacy of newer surgical procedures, full cognizance should be taken of these developments. It is hoped that this will result in a refinement of our indications for surgical operation and provide a solution in our continual quest to apply the right operation to the right patient.