Bladder rupture is a rare condition often seen in trauma patients that is associated with a high mortality.1Spontaneous, intraperitoneal rupture is even rarer in the literature. In this case report we present a middle-aged woman presenting to the emergency department (ED) with abdominal pain, the need to strain to void, and gross hematuria with prior history of urological procedures and cervical cancer. A computed tomography (CT) cystography revealed an intraperitoneal bladder rupture, and the patient underwent an emergent laparotomy. The patient’s postoperative course was uneventful and she was discharged with a Foley catheter. This case represents the importance of keeping bladder rupture in the differential diagnosis even without a history of trauma. Furthermore, an expeditious diagnosis, preferably with CT cystography, and management of the rupture is essential in assuring fortunate outcomes.TopicsBladder rupture, urological emergencies, spontaneous bladder rupture.