Organ abscesses caused by Streptococcus anginosus are relatively rare. We report the case of an elderly woman with splenic abscess caused by S. anginosus bacteremia after urinary tract infection. An 82-year-old woman had a history of frequency of urination, urgency, and fever with chills for over 10 days prior to admission. An abdominal computed tomography (CT) scan performed in the emergency room revealed a low-density lesion in the spleen, kidney cysts, some exudation around the kidney, and cystitis should be valued. She was treated with ceftriaxone and imipenem/cilastatin. After admission, the blood culture yielded positive results for S. anginosus. A contrast-enhanced abdominal CT scan showed that the low-density lesion previously found in the spleen was smaller than before. After percutaneous drainage of the splenic abscess and treatment with piperacillin/tazobactam based on the antibiotic sensitivity pattern, repeated abdominal CT scan revealed a significant reduction in the low-density lesion. The patient was discharged without recurrence or complications. A systematic review of organ abscess caused by S. anginosus bacteremia was performed. To our knowledge, there has been no report of splenic abscess caused by S. anginosus bacteremia secondary to urinary system tract infection, although urinary tract infections are also an important source.