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Spleen enlargement is a common problem we come across. Sometimes it may be just an ultrasound finding and may not have any major clinical problem. Spleen enlargement can be caused by various disorders. It can be a disorder like portal hypertension or liver disease where the Spleen enlargement is a sign and there is nothing wrong with thee spleen and it enlarges because of the liver disease and portal hypertension. There are intrinsic diseases of the spleen like splenic disorders, haemolytic anaemia, kala azar malaria, lymphomas and blood cancers can also cause splenic enlargement. So it is important that once you have a splenic enlargement, we undergo a complete thorough checkup and look at what are the reasons for the splenic enlargement. An enlarged spleen can be shrunk in size by treating the underlying diseases like if you have portal hypertension, then by doing a surgery or a procedure the spleen size can come down or we treat the underlying infection or the underlying haematological disorder the spleen size can come reduce, but there is also a way of reducing the spleen size by embolizing or blocking the artery which is supplying blood to the spleen. This is called as splenic artery embolization which is usually done by interventional radiologist and it is an effective way of reducing the spleen. In some cases the spleen size may be so large that they will require surgery or removal of spleen because they causes symptoms of heavy pain and discomfort and the blood counts coming down because the spleen is a place where all the red blood cells and the white blood cells gets destroyed. So there is something called as hypersplenism where they require surgery.