Background: Spleen is one of the most injured organs among blunt abdominal trauma. Spleen injuries were representing 45% of the total blunt abdominal injuries that threaten life. Non-operative management (NOM) proved to be one of the most secure techniques in the management of spleen injuries. Objectives: To evaluate the outcome of operative and non-operative management of blunt abdominal trauma with splenic injury at Aswan University Hospital. Patients and methods: In this prospective non-randomized controlled study, 42 patients with blunt splenic injury were admitted to the emergency unit during the period from December 2020 to December 2021.Result: Our findings revealed that there was a non-significant difference between study groups regarding gender , age, mode of trauma and Total leukocyte count (TLC) (P >/= 0.05). but There was a statistically significant difference between study groups regarding imaging investigations in ultrasound (U/S) and complete blood count in hematocrit and hemoglobin (P <0.05) and CT with a contrast among Grades 1, 2,3, and 4 of spleen injuries, systolic and diastolic blood pressure, and Pulse rate (P < 0.001). Conclusion: For spleen injuries, non-surgical management is the most secure because of fewer complications, preserving spleen functions, and reducing blood transfusion compared to surgical management. INTRODUCTION:Trauma is the fourth cause of death in the overall population and the first one in individuals below the age of 40 in Western countries. 1 Abdominal trauma can be classified as blunt or penetrating according to the agent and its mechanism of action. 2 The spleen is the most frequently injured organ in abdominal blunt trauma, mainly because of its highly vascularized