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The term diverticular disease or diverticulosis is used to describe the presence of diverticula that do not exhibit inflammation or any other complications. Diverticular disease is a growing problem in developing countries mainly by changes in diet becoming more like industrialized countries. The management of diverticulitis has evolved in recent years toward more conservative strategies or minimally invasive techniques. This review focuses in minimally invasive management of perforated diverticulitis and purulent peritonitis. In appropriately selected and classified patients, this alternative reduces morbidity and mortality of laparotomy and allows management of complications.