Solitary diverticulum of the cecum is a benign condition uncommon in the Western world, and with a higher incidence in Asian population. They are usually asymptomatic, and manifest clinically only with complications such as inflammation, perforation, or bleeding. They are a rare cause of acute abdominal pain, clinically similar to acute appendicitis, with tenderness in the right lower quadrant, fever, and leukocytosis. In spite of the information provided by ultrasonography or CT scans, a correct preoperative diagnosis is still difficult to reach, and is usually arrived at in the operating theater; differentiation from a neoplasm may be also sometimes complicated, and a wide surgical resection is usually required for such cases. We report on 5 cases of inflammation and perforation of a solitary cecal diverticulum, and perform a literature review.