Background Distal pancreatectomy traditionally included splenectomy; the spleen, however, is an important organ in the immunologic defense of the host and is worthy of preservation. The aim of this research was to study the feasibility,safety and clinical effects of spleen and splenic vessel-preserving distal pancreatectomy.Methods A retrospective review was performed for 26 patients undergoing distal pancreatectomy for benign or low grade malignant disease with splenectomy (n=13) or splenic preservation (n=13) at the First Hospital of Sun Yat-sen University and Guangdong General Hospital in Southern China from May 2002 to April 2009.Results All 26 pancreatectomies with splenectomy or splenic preservation were performed successfully. There was no statistically significant difference between two groups in mean operative time ((172±47) minutes vs. (157±52) minutes, P ＞0.05), intraoperative estimated blood loss ((183±68) ml vs. (160±51) ml, P ＞0.05), incidence of noninfectious and infection complication and mean length of postoperative hospital stay ((10.1±2.2) days vs. (12.1 ±4.6) days, P ＞0.05). The platelet counts examined one week after operation were significantly higher in the distal pancreatectomy with splenectomy group than the other group ((37.3±12.8)×109/L vs. (54.7±13.2)×109/L, P ＜0.05).Conclusions Spleen-preserving distal pancreatectomy appears to be a feasible and safe procedure. In selected cases of benign or low-grade malignant disease, spleen-preserving distal pancreatectomy is recommended.