The purpose of this paper is to point out that although the incidence of ruptured splenic artery aneurysm is a rare occurrence, it should be considered in the differential diagnosis of acute abdominal pain. The case reported is a 21-year-old white woman who presented with acute abdominal pain for 24 hours. While being evaluated in the emergency room, her splenic artery aneurysm ruptured. The diagnosis was made by use of ultrasound, computerized tomography, and exploratory surgery. In spite of a critical and life-threatening episode, the patient survived. Even though there is disagreement about the necessity for surgical intervention for asymptomatic aneurysms, this case reinforces the recommendation for surgical excision.