Aim: To describe B-mode sonographic patterns of splenic metastases and to evaluate clinical data regarding tumour staging, kind of tumour and survival of patients with splenic metastases.Methods: From 1988 till October 2002, about 168000 abdominal examinations were performed in an internal ultrasound laboratory. During this time, n = 59 patients with splenic metastases were detected who qualified for the retrospective study design. The following data were evaluated: echomorphology of splenic metastases, tumour staging, kind of underlying tumour, and survival rates of patients with splenic inetastases.Results: The median age of patients was 61.8 years (SD +/- 10.9). Lesions were hypoechoic n = 19 (32%), isoechoic n = 15 (25.5%), hyperechoic n = 10 (17%) und complex n = 15 (25.5%). A hypoechoic rim was found in n = 18 patients (31%). An additional spread into other organs was seen in 56 cases (95%). Underlying cancers were carcinoma of unknown primary tumours (CUP) n = 12 (20.3%), lung cancer n = 11 (18.6%), ovarian cancer n = 7 (11.9%), colorectal cancer n = 6 (10.2%), breast cancer n = 6 (10.2%), malignant melanoma n = 5 (8.4%), and others n = 12 (20.3%). The median survival time for all patients was 8.7 months. The worst prognosis within the subgroup analysis was found for patients with CUP-syndrome who had a median survival time of 2.7 months.Conclusion: The sonographic pattern of splenic metastases is variable. Metastases to the spleen indicate a terminal stage cancer disease and is associated with an extremely short survival time. 20% of underlying cancers were CUP-syndromes with the worst prognosis of all subgroups.