We describe the clinical course of 20 patients considered for laparoscopic splenectomy. One patient was excluded on the basis of preoperative angiography findings and two (10.5%) were converted to open surgery. The first patient in the series was converted for a hemorrhagic incident and the eight patient, who had a 34 cm spleen, for dissection difficulties. In the remaining 17 patients who successfully underwent laparoscopic splenectomy, no mortality was reported and there were four postoperative complications (23.5%). Mean operating time was 3 h 40 min (135-300 min). After a mean postoperative stay of four days, all patients, except two, were back to normal activities within 2 weeks of hospital discharge. Preoperative splenic artery embolization was begun with the third patient and was found to significantly reduce operative blood loss and make the procedure easier to perform. Laparoscopic splenectomy has become our procedure of choice for elective removal of normal-sized or moderately enlarged spleens.