Thirty-three patients with splenic injuries were treated with splenic salvage techniques. These patients were seriously injured trauma victims, often with multiple organ system damage. Hemostasis of the spleen was achieved with topical agents in 26 patients. Six patients required suture repair, with one hemisplenectomy. The postoperative complication rate was 37%; however, none of the complications could be attributed to the splenic repair. No patient required reoperation for control of bleeding. There were no subphrenic abscesses, and delayed rupture of the spleen could not be established. Splenic salvage can be done safely in selected patients. Young patients, those with isolated splenic injuries, and those in whom the repair will not unduly complicate the operation should be considered for this procedure.