Purpose: The patient is a 65 yr old Caucasian man who comes to the office complaining of abdominal pain, bloating and a 50 lb. weight loss over the last year. As part of the initial workup, an EGD was normal and he was sent for abdominal films which showed extensive diverticula involving 50 centimeters of the jejunum just distal to the ligament of treitz. He had an exploratory lap with lysis of adhesions along with resection of the aforementioned segment of small bowel. Post op he did very well and to date, almost 1 year later, has had no other symptoms and has gained his weight back. Acquired jejunoileal diverticula are a rare clinical entity that has been increasingly recognized in recent years. The incidence varies from 0.2% to 1.3% in autopsy studies to 2.3% when assessed with enteroclysis. Clinical presentation varies from asymptomatic to chronic abdominal pain/nausea and vomiting/flatulence/diarrhea and malabsorption. The location of small bowel diverticula is predominantly in jejunum accounting for 80% with ileal involvement (15%) and both (5%) accounting for minority of cases. The pathogenesis is herniation of mucosa and submucosa through the muscular layer of the bowel wall on the mesenteric border of the bowel, a characteristic that was described more than 200 years prior when the first cases of acquired jejunoileal diverticulosis was published by Sommering and Baillie. Small bowel diverticula remain asymptomatic in 60 to 70% of cases, however, chronic symptomology include vague abdominal pain, functional pseudoobstruction, and low-grade gastrointestinal hemorrhage. Acute complications may arise which include diverticulitis with or without abscess or perforation, massive gastrointestinal hemorrhage and intestinal obstruction. The specific diagnosis of Jejuno-ileal diverticulosis is usually difficult to ascertain and requires radiologic contrast studies to evaluate. Upper gastrointestinal examinations such as abdominal X-rays and small bowel follow-through are required for initial evaluation with CT imaging and enteroclysis reserved for patients with persistent abdominal signs and symptoms but nondiagnostic standard upper and lower gastrointestinal contrast studies. Endoscopy with extension into small bowel have proven limited benefit in diagnosing small bowel complications from diverticula, however it's utility in emergency situations are limited. Unfortunately diagnosis is rarely made before diagnostic laparoscopy or exploratory laparotomy is performed. Most of these procedures are performed in the situation of acute complications such as perforation, abscess, mechanical obstruction, or hemorrhage requiring resection of the affected bowel.