Posthepatitic cirrhosis is usually complicated with portal hypertension, and the latter often causes hypersplenism. Yet, there is controversy about whether splenectomy is necessary for those patients with combined hypersplenism. Those who hold the view of spleen preservation believe that splenectomy will impair immune function, increase the chance of infection and the occurrence of liver tumors, and meanwhile increase the risk of portal vein thrombosis. Those who advocate for splenectomy believe not only that as one of the main surgical treatment methods for portal hypertension, synchronous splenectomy can decrease the portal vein pressure, reduce the occurrence of gastrointestinal bleeding and correct cytopenia, but that the diseased spleen will lead to immune suppression, and splenectomy can improve the immune function of patients, and simultaneously, it can also promote the regeneration of liver cells, improve liver function and inhibit the progression of liver fibrosis. At present, the two sides have different opinions on some issues comparing patients with splenectomy and spleen preservation, such as liver blood flow and portal vein pressure, liver function and blood system, occurrence of thrombosis, immune system and progress of liver fibrosis. Therefore, based on the existing clinical and experimental studies, the authors address the current status and research progress regarding whether splenectomy should be performed in patients with hypersplenism caused by cirrhotic portal hypertension, so as to improve clinical understanding and provide relevant information for clinical decision making.