Although hemorrhagic and thrombotic complications are known to occur with essential thrombocythemia, splenic infarction is rare. This illustration from the case report "Splenic Infarct as the Presenting Manifestation of Essential Thrombocythemia" (doi: 10.31486/toj.21.0073) shows a devascularized and ruptured spleen, along with pathology results (from left): bone marrow biopsy showing an increased number of megakaryocytes with hyperlobated nuclei, bone marrow aspirate showing cellular marrow with a megakaryocytes cluster, and peripheral blood smear showing increased platelets and platelet clumps.