Background: Trauma is the leading cause of death below 50 years of age. Management of blunt abdominal trauma has changed from early surgical intervention to non–operative management due to advents of interventional radiology, endoscopy and minimal access intervention. Methods: We performed a unicentric, retrospective and prospective study of 20 patients with blunt abdominal trauma with isolated splenic injury from September 2017 to August 2018 at a tertiary level hospital. Results: Male population of age group 21–30 years was the common. Road traffic accident was the leading etiology. Abdominal pain (85%) and tenderness (100%) were common. 20% patients were operated, 80% managed conservatively. Hemoglobin fall and an increase in abdominal girth are significantly associated (p value = 0.038 S and 0.001 S) with surgical management. Conclusions: A history, high index of suspicion and advance imaging are necessary to minimise delayed recognition. Patients with hemodynamic stability are candidates for non–operative management.