According to international guidelines, patients presenting with acute diverticulitis are offered lower endoscopy to rule out colorectal cancer. This practice is based on weak evidence. Recent studies have established that the incidence of colorectal cancer after acute diverticulitis is low. In case of complicated diverticulitis, with abscess or perforation, the incidence of colorectal cancer is higher. There is, thus, a lack of evidence supporting colonoscopy by uncomplicated diverticulitis, but if a patient presents with complicated diverticulitis, colonoscopy should be performed.