OBJECTIVES: Research has suggested that admissions for diverticular disease (DD) are on the rise in Western countries, particularly among a younger patient population.  However, relatively little is known about how this increase has impacted the use of surgical procedures for the management of DD.  The goals of this study were a) to determine temporal trends in the use of surgical procedures (laparoscopic colectomy [LC] and open colectomy [OC]) for DD, and b) to investigate temporal changes in surgical procedures among younger patients for the management of DD. METHODS: Using a nationwide commercial claims database, a retrospective cohort was identified who had undergone LC (n= 2095) or OC (n=5971) between 4th quarter, 2005 through 1st quarter, 2009.  2000 U.S. Census data was used to calculate age-adjusted temporal trends in the overall surgical procedure and logistic regression was used to determine the time trends in each surgical procedure, adjusting for age, gender, and the type of benefit plan. RESULTS: A total of 8,066 surgical procedures were performed during the study period (mean age=53 ± 11, 55.7% Male).  Quarterly mean number of surgical procedures(LC+OC) performed was 576 (SD=39) and the annual mean number of LC+OC from 2006 to 2008 was 2297 (SD=107).  Quarterly age-standardized surgical procedures(LC+OC) for DD declined by 9.26% for patients younger than 45, whereas overall surgical rate increased by 3.2% for older patients.  The odds of having a LC over OC declined by 8% each consecutive quarter (95% CI 0.91, 0.93) while controlling for other covariates. CONCLUSIONS: Data suggest that there was a slight decline over time in surgical procedures for younger patients.   The reasons for the decline in surgical procedures for younger patients may be due to recent studies suggesting that DD is not more aggressive in younger patients as initially reported, and that the conservative medical treatment may be more appropriate with this population.