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Ruptured splenic artery aneurysm (SAA), rare in the emergency department (ED), is a cause of hypotension and abdominal pain. Physicians should consider the possibility of this condition especially in patients with abdominal pain and hypotension. In this paper, we report the case of a patient with ruptured SAA presenting to the ED as an intraabdominal catastrophe and review the key features of this entity.