Splenectomy alone or in combination with other major operative procedures has been implicated as the cause of excessive morbidity and mortality. We retrospectively studied 151 consecutive patients with splenectomy performed between 1985 and 1992. Subsets of patients according to indication for splenectomy were compared with a cohort of patients having elective open cholecystectomy. Morbidity with elective splenectomy (11.5%) was not significantly increased over that with elective open cholecystectomy (6.8%). Morbidity with nonelective splenectomy (40.4%) was increased when compared with that of elective splenectomy (11.5%) or with elective open cholecystectomy (6.8%). Mortality was significantly worse for nonelective (10.6%) than for elective splenectomy (1%). Nonelective splenectomy should be recognized as one event in a cascade of events leading to excessive morbidity and mortality. Splenectomy should not be implicated as the sole or primary cause of such excesses.