A 17-year-old female with massive splenomegaly underwent partial splenic embolization (PSE) for hypersplenism. The postoperative course was characterized by recurrent painful splenic infarctions requiring hydromorphone PCA for an extended period resulting in an unanticipated, prolonged hospital stay. Massive splenomegaly treated with PSE may require an extended hospital stay to achieve pain control. Such patients may subsequently require transition to enteral opioids and weaning.