Review of splenic diseases in childhood, specific diseases affecting the spleen, and the spleen during pregnancy is discussed. Many pathological processes may affect the spleen during childhood and various disorders may been seen in adulthood and childhood. Lymphoma is the most common malignancy affecting the spleen. Accurate assessment of the spleen is essential in this disease because it can alter staging, influence treatment options and determine the overall prognosis. Saroidosis is an animistic disease which can involve any organ in the body, including the spleen, and both the radiologists and clinicians must be knowledgeable about its variable presentations. The spleen apparently gradually enlarges and therefore mild physiological splenomegal may be found in a woman undergoing imaging by the end of pregnancy or shortly after delivery.