Diverticular disease is one of the most common medical conditions affecting Western populations. Inflammatory complications are the most common manifestation of the disease and typically cause acute bouts of abdominal pain and fever. Chronic symptoms can also occur and can be mistakenly attributed to irritable bowel syndrome and rarely to inflammatory bowel disease. Alterations in peridiverticular bacterial flora are thought to play a role in the pathogenesis of diverticular inflammation. This article discusses the rationale and reviews the existing clinical data regarding the role of probiotics in the management of diverticular disease.