Splanchnic venous thrombosis is a critical yet often overlooked risk after splenectomy in hematologic patients.

• Incidence is 11.4%, rising to 20.7% with routine imaging and 15.1% in single-center studies.
• Major risk factors include splenic size and weight; age, BMI, and platelet count were not significant.
• Patients with myeloproliferative neoplasms, lymphoma, and thalassemia face the highest disease-specific risk.

Implementing shared guidelines will aid in personalized prevention and management strategies for these high-risk patients.