Splenic artery aneurysms are potentially life-threatening lesions with an uncertain propensity for serious consequences. These aneurysms are most often discovered incidentally in asymptomatic patients. Current practice standards suggest that definitive treatment should be undertaken in female patients in their childbearing years with lesions larger than 1 cm in diameter, in patients with lesions greater than 2 cm in diameter, in symptomatic patients and in patients with enlarging lesions. Patients with splenic artery aneurysms should be referred to vascular surgeons or vascular interventional radiologists for surgery or percutaneous embolization therapy.