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Objective: To bring some light on the question of the rationale for splenectomy in Ethiopian patients., Subjects and Method: Consecutive patients from the last 19 years treated at Tikur Anbessa Hospital were collected and classified mainly on etiological ground for a discussion on the indication and outcome., Results: During 1981-1999 EC corresponding to 1988-2007 GC, 155 patients had splenectomy in Department of Surgery, Tikur Anbessa Hospital Addis Ababa; splenectomies were common in young adult patients. The median age was 20-24 years and there was a slight preponderance of males. The most common reasons for splenectomy were hematological disorders and congestive splenomegally with esophageal varices. Splenectomy after trauma and perioperative removal of the spleen were few in number. Other reasons for splenectomy, such as abscess, cysts and haemangioma were rare. Five cases from the Pediatric age group were all from the first years of the study., Conclusion: the described series of splenectomies is high in number. That should be expected in countries like Ethiopia, where tropical conditions like schistosomiasis and malaria have a high prevalence causing splenomegally and where the removal of the spleen is often in combination with portoazygos disconnection. Splenectomies for other indications are similar in number in western countries. The functions of the spleen are very important and to some extent vital and splenectomy should not be undertaken unless there is a rational ground.