The data available for 338 cases of splenectomy in agnogenic myeloid metaplasia published since 1940 were retrieved from the literature and analyzed. The median survival of cases operated upon at an early stage of the disease (as judged by their hemoglobin level, platelet number, and splenic size) was compared with the survival reported in conservatively treated patients diagnosed at an early stage of agnogenic myeloid metaplasia. Survival time since diagnosis of patients with early splenectomy was similar to, or shorter than, that reported in conservatively treated patients with early agnogenic myeloid metaplasia.