170 adult patients with splenomegaly who visited the Department of General Medicine, Indira Gandhi Institute of Medical Sciences, Patna between May 2021 and April 2022 were the subjects of this cross-sectional observational study. The patients' whole clinical profiles and the cause of their splenomegaly were assessed. Splenomegaly was graded using Hacket's grading. Investigations that were relevant and thorough were done. The majority of patients were under 44 years old. Hematological causes of splenomegaly were the most frequent etiological group, accounting for 54.6% of cases, followed by congestive (24.4%), infectious (15.87%), and miscellaneous (4.6%) causes. Hacket's grade II patients make up the majority of splenomegaly cases (54%), followed by grades III (27%), I (12%), and IV (3%).The most frequent cause among haematological aetiologies was chronic myeloid leukaemia (25.28%) The most prevalent infectious cause was malaria. In 86% of instances, pallor was visible upon clinical examination. Hepatomegaly affected 43% of patients, icterus affected 25%, and lymphadenopathy affected 12% of patients. We compared the findings of our study with those of other studies and came to the conclusion that regional differences exist in the clinical profile and etiological spectrum of splenomegaly.