A female aged 62 yr developed a recurrence of chronic idiopathic thrombocytopenia 7 years after splenectomy. Two accessory spleens were identified and removed surgically. An increase in platelet count was seen. An analysis of the literature shows that extirpation of accessory spleens was successful in over 60% of the patients (32/52) with recurring idiopathic thrombocytopenia after splenectomy.