Introduction: Percutaneous drainage of diverticular associated abscesses is recommended when abscess size is greater than 3-5cm. However, the role of elective resection after developing a diverticular abscess is contentious. The primary aims of this study was to investigate long term readmission rates and the need for surgical interventions in patients who undergo a percutaneous drainage for acute diverticulitis. Methods: This was a population-based cohort study of all hospital admissions for acute diverticulitis in New South Wales, Australia. ICD diagnosis codes and ACHI procedural codes were used to identify relevant admissions between 2005-2020 from the Admitted Patient Data Collection (APDC). Results: There were 983 patients who required one or more percutaneous drainages which accounted for 0.94% of all admissions. 43% underwent a colonic resection either during the same admission or on subsequent admission. The main risk factors for subsequent surgery after initial successful management with percutaneous drainage were age less than 50 years (OR 1.74, 95%CI 1.23-2.47, p=0.002) and recurrent admissions (OR 0.39, 95%CI 21.02-73.63, p<0.001). Conclusion: Patients who require a percutaneous drainage for diverticulitis were at high risk of a recurrent admission for diverticulitis with approximately half having a readmission within 16 years. The subsequent need for surgical intervention was 26% during this time.