Since April 1980 ruptured spleens have been removed in seven patients (6-43 years old) and reimplanted into the omentum majus using a new operative technique. This procedure took about 15 min. Two patients died because of associated trauma to other organs. There were no complications due to this autologous, heterotopic transplantation. Four months after the operation elektrophoresis of immunglobulins, Howell-Jolly bodies and "pitted" RBCs were totally normalized. A 99mTc-scintigram with human albumin-millimicrospheres showed an intact phagocytosis and ingestion by the transplant. Therefore, good protection against infection is to be expected. The heterotopic autotransplantation of the spleen should be used in cases of splenic trauma if the clinical situation demands total splenectomy.