Abstract The spleen is the most commonly injured organ in blunt abdominal trauma. Patients with these injuries are increasingly being managed nonoperatively, with use of Splenic Artery Embolisation (SAE). Many of these patients receive lifelong prophylactic antibiotics as though they were asplenic. The aim is to seek robust evidence of splenic vascular integrity and immunocompetence following SAE, and consider whether lifelong antibiotic prophylaxis is necessary for trauma patients managed in this way. 2 separate literature reviews were carried out using the Medline database. One to assess literature pertaining to splenic tissue viability following embolisation, the other to find literature reviewing splenic immune function after embolisation. In the vascular viability arm, 21 articles were reviewed. 12 studies observed no splenic infarcts at all. 18 of the studies noted <10% splenic infarcts in their populations. Distal embolisation resulted in more infarcted areas of splenic tissue than proximal. 9 studies performed follow-up imaging and confirmed splenic tissue viability post-procedure. For the review of immunocompetence, the literature search resulted in 13 full text articles. There was no consistency of the immunologic marker used to test splenic immunocompetence post-SAE, but 11 of 13 studies confirmed preserved immunocompetence by their respective markers. The data do suggest preserved tissue viability and immunocompetence. Agreement is yet to be reached as to which immune marker definitively assesses immunocompetence, and the length of follow-up needed to investigate it. More research is required to confirm the suggestion from these data that lifelong antibiotic prophylaxis is unnecessary for trauma patients treated with SAE.