Introduction: Blunt splenic trauma is a common clinical scenario, and its management has evolved significantly with the introduction of non-operative management (NOM). This prospective observational study aimed to evaluate the parameters that determine the choice of treatment and to compare the outcomes of NOM and surgical management.Materials and Methods:This study included 30 patients with blunt splenic trauma over a one-year period. Patients were divided into non-operative (n=12, 40%) and operative (n=18, 60%) management groups based on their clinical and hemodynamic status. Results: The non-operative management group had significantly higher systolic blood pressure (130 mmHg vs. 96 mmHg, p<0.001), lower heart rate (90 bpm vs. 110 bpm, p=0.002), and higher hemoglobin levels (11 g/dL vs. 9.75 g/dL, p=0.003) compared to the operative group. The non-operative group had a lower median transfusion requirement (0.3 units vs. 3 units, p=0.004) but a longer median hospital stay (15.9 days vs. 9.4 days, p=0.029). The success rate of non-operative management was 83.3% (10 out of 12 patients). Conclusion: Non-operative management is a safe and effective approach in the majority of patients with blunt splenic trauma, provided that the patient is hemodynamically stable. The clinical and hemodynamic parameters at admission are crucial determinants in the selection of the appropriate management approach.