Whether or not splenic resection is needed for splenic marginal zone lymphoma is determined on a patient-by-patient basis. Splenectomy is usually required for patients with co-morbidities and significant splenomegaly. Splenic marginal zone lymphoma is generally an inert lymphoma and can be divided into three subtypes according to the site of involvement: extranodal mucosa-associated lymphoid tissue marginal zone lymphoma, splenic B-cell marginal zone lymphoma and lymph node marginal zone lymphoma. Among them, patients with splenic B-cell marginal zone lymphoma often have anemia and splenomegaly, and splenectomy can be performed if the splenomegaly is obvious. Meanwhile, extranodal mucosa-associated lymphoid marginal zone lymphoma can be further classified into gastric mucosa-associated lymphoid lymphoma and non-gastric mucosa-associated lymphoid lymphoma, and splenectomy is also needed if patients with gastric mucosa-associated lymphoid lymphoma suffer from gastrointestinal perforation, hemorrhage, or obstruction and other complications. It is recommended that patients with splenic marginal zone lymphoma should choose splenectomy according to their own conditions and follow the doctor’s instructions to avoid aggravation of their conditions.