Chronic Myelomonocytic Leukemia (CMML) is a blood malignancy that presents with splenomegaly in up to 40% of the patients; however, a pathological splenic rupture is very rare. We describe a 50-year-old male, who presented to emergency room with hypovolemic shock secondary to pathological splenic rupture. Patient underwent emergency laparoscopic splenectomy and stabilized. During the stay at hospital, his complete workup revealed the diagnosis of Chronic Myelomonocytic Leukemia. Although splenomegaly is common in CMML, it rarely result in its rupture and so this complication is often overlooked. This case is reviewed in the light of handful cases described in medical literature.
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