Although surgical procedures including Hassab's decongestion operation and splenectomy have been done for patients with esophageal or gastric varices and/or splenomegaly, the efficacy of these procedures on long-term prognoses of patients with hypertension remain to be elucidated. Thus, clinical features and outcome of 17 patients receiving splenectomy for hypertension between 2005 and 2017, consisting of 14 patients with cirrhosis and 3 patients with idiopathic portal hypertension (IPH), were retrospectively evaluated, and were compared to those of 46 patients with cirrhosis manifesting class A Child-Pugh scores seen between 2008 and 2014. Peripheral counts of leukocytes and platelets increased following splenectomy both in patients with cirrhosis and IPH, but liver function tests such as serum albumin levels decreased following the procedure in patients with cirrhosis, while such derangement did not occur in patients with IPH. In patients manifesting class A Child-Pugh scores, the mean survival days did not differ between 8 patients receiving splenectomy and 46 patients treated without splenectomy. Splenectomy was effective in improvement of liver function for patients with IPH, whereas was not effective for those with cirrhosis manifesting class A Child-Pugh score, and the procedure did not improve the long-term outcome of patients.