Diverticular disease is a benign condition with potentially lethal complications; an extensive review from the past year literature is discussed. It is our intention to focus on the evaluation and management of the patient with complicated diverticular disease, localized or generalized peritonitis, obstruction, diverticular fistulas, and massive hemorrhage. A good categorization of perforated diverticular disease is presented based on selected articles. We also include advances in antibiotic therapy and the role of radiology, fundamentally, computed tomography in the treatment of pelvic abscess. Finally, an algorithm as a guideline for the treatment of complications in diverticular disease is included.