Numerical simulation of the unsteady turbulent flow in a three-dimensional elbow diffuser is performed. The investigation is carried out with a commercial finite volume solver implementing the Reynolds averaged Navier-Stokes equations. Against the background of current research in DNS and LES, the modeling of most practically relevant turbulent flows continues to be based on this system of equations. For this reason it is important to evaluate the limitations of the Reynolds averaging approach with the associated turbulence modeling, in particular for the prediction of time-dependent flows. Verification and validation are presented; detailed measurements are compared with computations. While a great deal of research has focused on draft tube design, relatively little is known about the complex flow features present. The flow is analyzed over a wide range of operating conditions including part load. Topological changes in the flow patterns with the global characteristics of the diffuser are presented. Visualization provides extra insight into the complex flow. Forced and self-sustained time-dependent flow phenomena are captured. Falling into these categories are flow field fluctuations introduced by the runner, self-sustained vortex shedding phenomena, and the typical rotating helical vortex observed at part load. Additionally, the linear stability of measured inlet profiles is investigated, providing a fuller understanding of the basic instability mechanism.