Aggressive laparoscopic procedures can be used to manage pathologic lesions of solid organs. We attempted laparoscopic management of solitary symptomatic splenic cysts in four patients--two men and two women--ranging in age from 19 to 63 years (mean, 35 years). The cysts involved the whole spleen in one case, the upper pole in one, and the lower pole in two. We performed laparoscopic splenectomy in one case and laparoscopic unroofing of the cyst wall in three. In two procedures we successfully used needlescopic instruments. The duration of surgery and the volume of intraoperative bleeding were 300 minutes and 200 mL, respectively, for the splenectomy, and an average of 170 minutes (range, 120-240) and minimum volume, respectively, for the unroofing. There were no intra- or postoperative complications related to the laparoscopic procedures. The postoperative hospital stay was 9 days for the patient who underwent splenectomy and an average of 5.6 days (range, 5-7) for the patients who underwent unroofing. Laparoscopic management of splenic cysts is technically feasible and safe and has the advantages of reduced postoperative pain, shortened convalescence, and improved cosmesis.