The management of colonic diverticulitis is becoming more relevant for the immunosuppressed (IMS) population due to expanding indications for immunosuppression. There is a consensus regarding the timing and type of operation for the immunocompetent (IMC) population, and however for the IMS population, these decisions remain controversial. The IMS population typically includes those who have undergone a solid organ transplant and/or those who receive regular immunosuppressive therapy. The determination between complicated (intra-abdominal abscess, stricture, fistula, obstruction) or uncomplicated index episode of acute diverticulitis is a deciding factor for what type of management should be chosen for within or following that episode. Hartmann’s procedure is the most performed surgery following complicated diverticulitis in the emergency setting for immunosuppressed patients. Colectomy is another emergency surgery option; however, in the IMS population, it is associated with high morbidity and mortality compared to IMC population. As for the elective options, resection and primary anastomosis with or without diverting stoma appears to be safe in immunosuppressed patients. On the other hand, outcomes following elective colectomy in IMS patients are inconsistent.