The advantages of laparoscopic splenectomy over conventional splenectomy with regard to shortened hospital stay and rapid return to work have been described. Reports to date have involved a five trocar anterior approach. Having performed the anterior approach, we now present the lateral approach to laparoscopic splenectomy using four trocars. The lateral approach offers superior visualization and access to splenic hilar structures. Superior anatomic exposure, ease of dissection and minimal access attained suggest the lateral approach to be the approach of choice for laparoscopic splenectomy.