Littoral cell angioma (LCA) is a rare primary vascular tumor of the spleen that has been reported infrequently and variably in the radiology literature. We present a patient with LCA of the spleen who had only nonspecific low back pain and epigastralgia for several months. The imaging findings in unenhanced and contrast-enhanced CT, ultrasonography, as well as histologic findings are presented. The imaging findings and differential diagnoses of splenic tumors are discussed.