Klebsiella pneumoniae was recently reported to be the major pathogen causing pyogenic splenic abscess in Taiwan. To better understand the characteristics of K. pneumoniae splenic abscess, which may be helpful in alerting clinicians to this infection entity when dealing with a suspicious patient, patients hospitalized between January 1981 and December 2002 with the diagnosis of splenic abscess were included in a retrospective study. Among the 38 enrolled patients, 9 (23.7%) suffered from K. pneumoniae splenic abscess. Compared to those with non-K. pneumoniae splenic abscess, patients suffering from splenic abscess caused by K. pneumoniae had a higher prevalence of underlying diabetes mellitus (88.9% vs 37.9%; p = 0.006) and higher incidence of concomitant liver abscess (44.4% vs 0%; p < 0.001) caused by the same pathogen. When dealing with patients suffering from K. pneumoniae splenic abscess, clinicians should work up to exclude a concomitant liver abscess caused by the same pathogen.