Intro Immunosuppression represents a significant comorbidity and confounder in acute abdomen setting. In this context, patients often present later, with less symptoms and more complicated sepsis with increased risk of mortality as well as graft loss1. Acute diverticulitis is a common presentation of the acute abdomen with often non-operative management with good outcomes. Method 10 years of Retrospective records were gathered from 2014 to 2025. Patients with a background of renal or SPK transplant, presenting with acute diverticulitis were included. Basic demographic data were analyzed. Primary outcomes included admission mortality and length of stay. Secondary outcomes included operative management, non-operative interventions, subsequent readmissions within 30 days, conversion to operative intervention if originally managed non-operatively. Result 13 patients were identified during the study period. 11 were initially managed with non-operative management, 2 who underwent immediate open Hartmann’s procedure and 2 patients failed non-operative management requiring subsequent operative intervention. The average LOS for immediate intervention was 23.5 days shorter compared to the average 37 days of patients who failed non-operative management. The average LOS of patients who succeed with non-operative management was 3.8 days. Overall mortality was one in the immediate intervention group and one for non-operative group. Conclusion This study has demonstrated a role for non-operative management of acute diverticulitis in immunosuppressed patients post renal transplantation. However, significant clinical confounders modulated by immunosuppression mean there needs to be a lower threshold for surgical intervention in order to salvage patients. Reference 1.Batra, R., Rudnicki, Y., Stapleton, S. M., Gan, T., Mathis, K. L., & Kelley, S. R. (2022). Management of Diverticulitis in Renal Transplant Patients. American Surgeon, 89(2), 210–215.