Purpose: Splenic infarct is a rare and potentially severe medical condition that may require immediate surgical management. We describe a rare case of splenic infarct from splenic artery thrombosis following acute necrotizing pancreatitis. 23 year old man with a past medical history of schizophrenia and acute pancreatitis secondary to alcohol consumption a month prior to this admission was admitted for acute abdominal pain following binge drinking. The pain was described as sharp, constant, epigastric, radiating to the back, slightly decreased by pain medications and associated with nausea and low grade fevers. CT scan of the abdomen on admission showed necrotizing pancreatitis and retroperitoneal loculated collections. Antibiotics were started and percutaneous drainage of his collections was performed. On day 10 of his hospital stay his abdominal pain worsened. A repeat imaging of the abdomen showed acute infarction of the spleen likely due to thrombosis of the splenic artery. He went for an emergent exploratory laparotomy with splenectomy and debridement of the pancreatic necrosis and residual collections. Post-op he was managed with supportive care and was subsequently discharged home. Discussion: Splenic infarction is defined as an occlusion of the splenic vascular supply leading to parenchymal ischemia and subsequent splenic tissue necrosis. The infarct can be segmental or it may be more global, involving the entire organ. It was first described in Germany in1896 following endocarditis. The majority of causes are either infiltrative hematologic diseases that cause decreased blood flow of the splenic circulation, or thromboembolic conditions that produce obstruction of larger vessels. Other causes include embolic disorders, vascular disorders, autoimmune/collagen vascular disease, external trauma and post operative trauma. Other rare causes are amyloidosis, sarcoidosis, post partum toxic shock syndrome and ARDS. Unusual causes are malaria, pancreatitis, and cocaine use. Splenic vascular complications are seen in the setting of acute pancreatitis due to the anatomical proximity of these vessels to the pancreas. The Pathophysiology of splenic infarct includes thromboembolic events or decreased oxygen-carrying capacity to the spleen that lead to infarcts. The treatment is close follow up for cases with localized infarction or splenectomy for cases with more diffuse involvement. Conclusion: Splenic vascular complications must be considered in the differential diagnosis of acute pancreatitis with increasing abdominal pain.