Objective: To investigate the manifestations, diagnosis and management of duodenal diverticulum. Methods: The clinical data of 105 patients with duodenal diverticulum admitted to our hospital during two years and seven months were retrospectively analyzed. Results: Of the patients, the most common symptom was abdominal pain (54 cases), followed by the symptoms of sour regurgitation, nausea and vomiting (21 cases). The patients were diagnosed mainly by endoscopic and radiographic examination of gastrointestinal tract. Sixty-eight patients received conservative treatment, one of whom underwent duodenal diverticulization operation (Billroth II gastrectomy and gastrojejunostomy) later due to repeated recurrence of symptoms. The other 37 cases received surgical treatment, of which, 22 cases complicated by biliary tract diseases underwent related operations, and 11 cases underwent duodenal diverticulization (5 cases) or diverticulectomy (6 cases) due to recurrent diverticulitis, and 4 cases underwent other procedures. No obvious discomfort was found in all the 105 patients during one year of follow-up. Conclusions: The most common symptom of duodenal diverticulum is abdominal pain, and duodenal diverticulum is discovered mainly by endoscopic and radiographic examination of gastrointestinal tract. Conservative management is suitable for the majority of duodenal diverticula, and the indications for surgery should be strictly controlled.