Spleen is the largest organ of the mononuclear phagocytic system and is involved in all systemic inflammations, generalized haematopoietic disorders as well as metabolic disturbances. Perisplinitis, also known colloquially as “icing sugar spleen”, is a common autopsy finding. The capsule of the spleen becomes nodular, thickened and fibrotic, and it appears as though the spleen has been dipped in white icing. Over time, calcification may supervene. Perisplinitis can complicate any inflammatory process in the abdomen or pelvis and splenic sepsis, and it is also seen in patients with chronic obstructive pulmonary disease. It has been reported as part of CurtisFitz-Hugh Syndrome. Perisplenitis is seen as creamy yellow to white exudates or firm glistening “icing-like” plaques on the capsular surface, indicating active acute or regressed infection, respectively. It is usually secondary to generalised peritonitis or extension from local infection. Irregular pale tan plaques of collagen over the purple capsule known as “sugar icing” or “hyaline perisplenitis” which follows the splenomegaly and/or multiple episodes of peritonitis that are a common accompaniment to cirrhosis of the liver. Splenic infarcts and perisplenitis may give rise to left hypochondriac pain.