Background: Hypersplenism remains a major problem in patients with chronic liver disease. For a long time splenectomy either open or laparoscopic was the definitive line of treatment for such conditions. However, sometimes the operation may be dangerous for some patients with poor liver condition and patients unfit for general anesthesia. So in the recent years partial splenic embolization (PSE) has been used as an alternative for splenectomy in such patients.   Patients and methods: This comparative prospective study was conducted on 28 patients, with thrombocytopenia secondary to hypersplenism as the main clinical presentation, admitted to El-Demerdash and Ain Shams University Specialized hospitals between January 2015 and January 2017. They were classified into 2 groups A and B, with 14 patients in each group. Group A patients were treated by splenectomy, with prior upper GIT endoscopy to determine the presence of esophageal varices to be banded or ligated, while group B patients were treated by partial splenic embolization (PSE) aiming at establishing occlusion of 50-70% of the distal branches of the splenic artery. The study compared both groups as regard the improvement of the blood indices, RBC, TWBC and platelet count, length of hospital stay, and postoperative complications.   Results: There was statistically significant difference among both groups as regards operative time, estimated blood loss, rate of blood transfusion and length of hospital stay. Multiple blood transfusions and blood loss was markedly increased in the splenectomy group. Postoperative complications were reported to be 78.6% in the splenectomy group, which was significantly higher than in the PSE group, 57.1% of patients. In all studied patients, all the indices of the blood count showed significantly increased postoperative values compared to the preoperative values at the one month follow up. The mean RBC count did not differ significantly between both study groups postoperatively, whereas the mean TWBC and platelet counts were significantly higher in the splenectomy group than in the PSE group (p < 0.05, p < 0.01).   Conclusion: Both techniques are followed by marked improvement of the platelet count but improvement was much better after splenectomy. The study also presented PSE as a good therapeutic modality in patients with hypersplenism secondary to chronic liver disease with the advantages of being a simple procedure performed under local anesthesia with fewer post-procedure complications.