Objective. To conduct a clinical analysis of the surgical treatment of patients with spleen injuries in the Astrakhan region. Materials and methods. The data of 110 patients with spleen injuries of different sex and age who were hospitalized on an emergency basis in hospitals of the Astrakhan region and were in surgical departments from August 2017 to December 2022 were analyzed. Results. An analysis was made of 110 clinical cases of spleen injury in the Astrakhan region for the period from 08.2017 to December 2022. The distribution of patients by sex and age was carried out, the nature of spleen injuries, the localization of spleen wounds, the time of admission of patients from the moment of injury, the features of clinical manifestations, the choice of diagnostic method and surgical intervention were studied. Postoperative complications and causes of mortality after spleen injury, the number of bed-days spent in the hospital, depending on the type of surgical intervention, were analyzed. Conclusion. The use of hemostatic sutures for isolated splenic injuries makes it possible to increase the number of organ-preserving operations. In case of total ruptures, multiple wounds and damage to the vascular pedicle, it is recommended to perform splenectomy with autotransplantation of splenic tissue.