Laparoscopic splenectomy is performed routinely in patients with small and moderately enlarged spleens at specialized centers. Large spleens are difficult to handle laparoscopically and hand-assisted laparoscopic splenectomy might facilitate the procedure through enhanced vascular control, easier retraction and manipulation, manual guidance of endostaplers, and clip appliers. A technique of hand-assisted laparoscopic splenectomy is described.