This video discusses the diagnostic and therapeutic approach utilizing laparoscopy for splenic abscesses after failed percutaneous drainage. We present a safe and effective management option in a hemodynamically stable 58 year old man with a history of DM, HTN, PVD, CKD, and CAD who presented with a 1 day history of diffuse severe abdominal pain associated with chills, nausea and vomiting. Initial CT scan showed a large splenic abscess and air fluid collections within the spleen along with inflammatory changes adjacent to the descending colon and around the spleen. On physical exam his abdomen was distended with tenderness to deep palpation, no rebound tenderness and no masses were palpated. He was started on empiric IV antibiotics and was sent to IR for percutaneous drainage of the splenic abscess. 100cc of purulent fluid was aspirated from the abscess. This fluid was sent off for gram stain, culture, fungal and cytology. Finally bacterial growth from the specimen was Fusobacterium. The patient was treated with conservative management, IV antibiotics and drainage for one week. However, he continued to have cyclic fevers, persistent leukocytosis and was not improving clinically. The decision was made to proceed with laparoscopic splenectomy. Intraoperatively, we discovered a large posterior splenic abscess with multiple loculations. This was also associated with free fluid in the paracolic gutters and multiple adhesions. The spleen was carefully dissected and removed in a silastic retrieval bag. The patient tolerated the procedure well.