Acquired diverticular disease of the colon is very common in the North American population. Atypical presentations are usually due to complications and rarely the predominant complaint may be related to an associated fistula. Thigh abscesses due to colocutaneous fistula represent an uncommon complication of sigmoid diverticulitis. In rare cases, a thigh abscess may be the only symptom, but gas in the thigh should raise the index of suspicion for bowel pathology. We report the second known case of a left-sided sigmoid diverticulitis leading to an isolated right thigh abscess with no gastrointestinal symptoms.Key words: Diverticulitis -Colocutaneous fistula -Sigmoid colon -Surgery A cquired diverticular disease of the colon is very common in the North American population, affecting up to 10% of persons greater than 45 years of age and approximately 80% of those over 85.