The authors report a rare case of splenomegaly, caused by recurring splenic torsion in a 31-year-old patient. On the basis of this experience and literature data, pathogenetic, symptomatological, diagnostic and therapeutic aspects are discussed. Analysis of the clinical history and diagnostic procedures confirm the difficulty in ascertaining this condition preoperatively. In any case, splenic torsion should be considered in the differential diagnosis of painful splenomegalies.