Abstract: Objective To compare the effect of laparoscopic splenectomy (LS) versus open splenectomy (OS) for the treatment of hereditary spherocytosis (HS) in children. Methods A retrospective analysis was performed in 24 children with hereditary spherocytosis admitted to Shanghai Children's Medical Center from January 2012 to July 2019,including 12 cases in LS group and 12 cases in OS group by propensity score matching.OS group was treated with open splenectomy,and LS group was treated withlaparoscopic splenectomy.The treatment effects and related complications were compared between the two groups. Results The laparoscopic splenectomy was superior to the open splenectomy in the length of incision (3.1±0.5 cm vs 15.0±1.3 cm),the amount of bleeding (7.0±0.8 ml vs 20.2±11.4 ml),the time to ambulation (32.4±4.5 h vs 55.4±7.4 h),the incidence of postoperative complications (25% vs 50%),but the operating time in the OS group was significantly shorter than that in the LS group (102.3±13.2 h vs 115.3±11.3 h) (all P<0.05).The level of hemoglobin in the two groups was higher than that before operation,and the symptoms of anemia were obviously improved after treatment.In addition,the number of platelets in the two groups increased in different degrees compared with preoperation,but gradually decreased at 1 month after operation,and decreased to the normal range at 12 months after operation. Conclusion For children with hereditary spherocytosis,the clinical efficacy of laparoscopic splenectomy is superior to open surgery,with fewer complications,faster recovery,less invasive,etc.