Objective: To investigate the diagnosis and treatment of the space-occupying lesions of the spleen. Methods: The clinical data of 22 patients, who had space-occupying lesions of the spleen, admitted from January 1992 to December 2009 were retrospectively analyzed. Results: Of the entire group, 18 cases were benign space-occupying lesions that included 4 cases of splenic cyst, 11 cases of splenic hemangioma, and 3 cases of splenic abscess; 4 cases were malignant space-occupying lesions that included 2 cases of malignant lymphoma, and one case each of splenic metastasis from pancreatic cancer and metastases in the liver and splenic following surgery for stomach cancer. Twenty-six patients underwent total splenectomy and 2 patients underwent partial splenectomy. Of the 2 malignant lymphoma and 2 splenic metastasis patients, one case was lost to follow-up, and the other 3 cases died one year, 2 years and 2.5 years after operation, respectively. All the benign patients were cured. Conclusion: The diagnosis of space-occupying lesions in the spleen is mainly based on clinical manifestation and imageological examination. Differentiation of benignancy or malignancy of the lesions depends on contrast-enhanced ultrasonography, CT or selective splenic artery angiography. For these patients, surgical treatment is the major therapeutic alternative, while adjuvant radiotherapy and chemotherapy is required for the malignant cases.