The spleen loss leads to increase the risk of sepsis, pyelonephritis, pneumonia, and pulmonary embolism throughout the lifetime of patients with splenic trauma. Regarding the sensitivity of the spleen and the importance of appropriate therapies for spastic trauma, this study aimed to determine the consequences of spinal trauma based on different therapeutic methods. This retrospective cohort study was conducted on the splenic trauma patients who were referred to Rasool Akram Hospital in Tehran, Iran, during 2011-2017. All medical records of 133 splenic trauma patients were gathered from 2011-2017. The data were gathered related to ultrasound, and computed tomography scan or other diagnostic methods of the patients admitted in the surgical ward. Finally, splenic trauma patients with a surgical approach were compared to the subjects with a non-surgical approach. Surgical and non-surgical approaches were performed on 80% (n=104) and 20% (n=26) of the subjects, respectively. There was a significant difference between the two groups regarding the length of intensive care unit stay and total hospitalization duration. The comparison between the two groups showed that there was no significant difference in term of the related side effects (P>0.05). Overall, 80.8% (n=84) and 96.4% (n=27) of the patients were discharged in surgical and non-surgical groups, respectively. In addition, 19.2% (n=20) and 3.6% (n=1) of the cases died in surgical and non-surgical groups. The comparison of survived patients showed that there was a significant difference between the groups (P=0.045). This study showed that there was no difference regarding the consequences of surgical and non-surgical approaches in patients with splenic trauma. The length of hospital stay was shorter in the non-surgical group, compared to that of the surgical group. The most commoncause of trauma in both groups was car accidents. Retroperitoneal hematoma was the most common intraabdominal trauma. The mortality rate was higher in the surgical group in comparison to that of the non-surgical group.