Patients with congenital asplenia are among those with congenital cyanotlc cardiac disease for whom no definitive surgery has been devised. If possible these should be separated clinically from patients for whom surgical therapy is pertinent. A means for identification of the congenitally asplenic child is to demonstrate symmetry of the liver roentgenologically. By this method the shadow of the lower edge of the liver is roughly horizontal in the asplenic. In the normal the edge of the liver forms an oblique shadow.