Spontaneous splenic rupture is an extremely rare complication in patients who received haemodialysis. We describe a 51-year-old woman who underwent regular haemodialysis and was admitted because of sudden onset of abdominal pain, hypovolemic shock and dizziness. Haemoperitoneum caused by spontaneous rupture of spleen was found on abdominal CT scan. Emergency splenectomy was performed, and the patient was discharged 9 days after the admission. This report demonstrates that spontaneous splenic rupture requires a high index of suspicion for diagnosis in a patient who received haemodialysis with abdominal pain and should be considered in the differential diagnosis when a patient who received haemodialysis without any trauma history has abdominal pain with unexplained hypovolemic shock.