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Nodular or diffuse splemomegalies may be determined by several causes; in most cases, clinical and serological data are diagnostic but there are still rare conditions or equivocal clinical presentations in which a direct evaluation may be useful. FNC of the spleen was first used for the diagnosis of leishmaniasis and was then extensively used in the Seventies by the Swedish school. The fear of haemorrhage first, and the subsequent development of other non invasive diagnostic techniques have limited, over time, the diffusion of splenic FNC. Nonetheless, there still are some clinical situations in which FNC, despite some prejudices, may contribute to the diagnosis of nodular or diffuse splenomegalies. Moreover splenic FNC may be conveniently performed under ultrasound control, without complications, provided that the whole procedure is properly performed, and being aware that mononucleosis and hemorrhagic diathesis are definitive contraindications.