Hyaline perisplenitis refers to the presence of a thick layer of tan-white nodules and fibrous plaques on splenic surface. It is often an incidental finding at autopsy. It may be seen in patients with cirrhosis of liver who undergo multiple bouts of peritonitis. The patient is usually young to middle-aged and presents with acute left upper quadrant pain which may simulate acute pleuritis or even chest pain. Multiple rounds of inflammation of the splenic capsule and peritoneal covering leads to deposition of collagenous nodules on splenic surface. The appearance has been likened to "sugar icing" or "snow-covered" spleen. Case courtesy of: Dr. Sunil Swami, Assoc. Professor of Pathology, Swami Ramanand Teerth Rural Government Medical College, Ambajogai, Maharashtra, India.