The paper contains a concise review of the current literature on the splenic abscesses and presents an unusual association of multiple splenic abscesses with normotensive hydrocephaly to an elderly patient, treated by ventriculo-cardiac shunting and splenectomy as an one stage procedure performed by a combined surgical team (neurosurgeon, vascular surgeon and general surgeon), with a favourable outcome. As far as the authors know, this is the first communication of multiple splenic abscesses associated with adult hydrocephaly treated by a simultaneous surgical approach.