Introduction: Comprehension of the role of spleen in immune processes and definition of laparoscopic splenectomy have led to narrowing of indications of splenectomy, preferring spleen-sparing surgical approaches if splenectomy will be performed for indications other than hematological ones, and increased performing of laparoscopic splenectomy in particularly for hematological diseases. In our study, we aimed to discuss changes in surgical approaches and indications for splenectomy with emerging technologies. Materials and Methods: 204 splenectomy cases performed between 2010-2018 in our clinic have been retrospectively studied with attention paid to indications and surgical techniques. Results: Splenectomy was performed for 38 cases due to trauma, 58 cases due to hematological diseases, out of a total of 312 gastric cancer surgery cases, 47 combined with gastrectomy and 23 combined with surgery for other abdominal malignancies, 8 cases due to hydatid cyst, 6 cases due to abscess, 9 cases due to spontaneous splenic hemorrhage, 6 cases due to massive splenomegaly, 4 cases due to migratory spleen. Out of 58 hematological cases, open splenectomy was performed for 8 cases due to large spleen size, laparoscopic splenectomy was performed for 46 cases and 4 cases were laparoscopic surgery that later converted to open splenectomy. For cases with other indications open splenectomy was performed for 143 cases and laparoscopic for 3 cases. Conclusion: Because conservation remains at the forefront of the traumatic splenic lacerations, the most common indications of splenectomy; this group has composed 18,6% of the presented 204 cases, hematological splenectomies and splenectomies combined with adjacent organ malignancy surgeries are with increasing numbers and predominantly performed by laparoscopic method.