Colonoscopy – induced spline injury. Colonoscopy – induced spleen injury is a rare complication of this procedure. It has a low incidence, but there is a tendency to increase in the last period. There are several possible mechanisms of trauma. Computer tomography is the most useful method in diagnosis, and was performed in all cases. A review of the specialized literature was performed in order to determine the number of cases of reported splenic injury after colonoscopy in the period 2015-2021. We determined that 75.4% from the patient were female. Previous surgery is a importat risk factor. The mean age of the patients is 65 years. Most of them present clinical picture of lienal trauma during 24 hours from the procedure. Treatment options vary depending on multiple factors. The treatment is targeted to stop the bleeding. It depends on hemodynamic stability of the patient, the grade of lesion, possibilities of the institution. Splenectomy by laparotomy it is still more favorable. Angioembolization is a option for patient with comorbidities, active bleeding, but stable hemodynamic. Conservative management must be applied carefully, in accordance with the criteria of selection. It is very important for doctors to take into the consideration this diagnosis, because it can be life threatening in case of delayed diagnostic and active haemorrage.