Historically, colectomy was recommended after two episodes of diverticulitis to prevent catastrophic recurrence without specific consideration of the lived experiences or preferences of patients. But recent research observes that future episodes are not more likely to be associated with perforation and emergency surgery [1–5]. Over the past decade, studies have revealed that the reduction in mortality with a prophylactic colectomy is minimal, and patients as well as professional organizations now advocate that the focus be shifted to improving quality of life [6, 7]. This requires that the values, preferences, and goals of the patient are explicitly elicited, shared between patient and clinicians, and are core to care planning for recurrent diverticulitis. As such, management guidelines now recommend an individualized approach in considering colectomy in patients with recurrent diverticulitis [8–10]. Given the significant heterogeneity in severity of disease and presentation, proper patient selection is critical for optimizing outcomes. The complexity of diverticulitis management, which includes conservative medical therapy, dietary modifications, antibiotic treatment, and surgical intervention, necessitates an approach that integrates both clinical guidelines and patient preferences. It is in this condition of heterogeneity and complexity that shared decision-making between patient and clinician is imperative.