Primary liver sarcoma represents less than 1% of all primary liver tumors. Hepatic undifferentiated embryonal sarcoma (HUES) is included in the histologic group of primary liver sarcomas. HUES is a rare malignant liver tumor with a low incidence in the adult population. At moment there is no tumor marker that increases suspicion or diagnosis Early diagnosis is key to rise the possibilities of long-term survival. It has currently improved its prognosis through multidisciplinary management with surgical resection and chemotherapy. This case report presents a 20-year-old female patient with acute abdomen and anemic syndrome secondary to spontaneous rupture of a HUES requiring medical management initially based on resuscitation and arterial embolization with subsequent surgical resection.