Splenic artery aneurysms are the most common visceral artery aneurysms and are known for their potential for rupture. Pregnancy and portal hypertension have been known as major risk factors. With improved methods of diagnosis and minimally invasive therapy, management and outcome of SAA may change significantly. SAA may rupture at any age. When rupture of the aneurysm occurs, the mortality rate remains low if immediate resuscitation is performed and an aggressive surgical approach is taken. Conservation of the spleen might have been preferred.