The incidence of diverticulosis and diverticular disease (DD) of the colon, including acute diverticulitis, is increasing worldwide, and becoming a significant burden on national health systems in terms of direct and indirect costs. Thus, significant efforts are now being focused to identify the correct therapeutic approach to treat symptomatic patients and to prevent diverticulitis. Fiber, non-absorbable antibiotics, 5-aminosalicylic acid and probioticsare currently being investigated in this way. Unfortunately, current evidences on the effectiveness of some medical treatment in preventing acute diverticulitis recurrence are still lacking. The effectiveness and the future perspectives of these treatments are discussed herein.