This white paper describes splenic and nodal incidental findings found on CT and MRI. Recommendations for management are included. This represents the third of 4 such papers from the ACR Incidental Findings Committee II, which used a consensus method based on repeated reviews and revisions and a collective review and interpretation of relevant literature. Topics include descriptions of appearances of several types of splenic lesions and, the importance of size and distribution of lymph nodes. Flowcharts are provided for reference. © 2013 American College of Radiology.