The spontaneous rupture of hepatic neoplasms in Western countries has an incidence of less than 5%. Hepatocarcinoma is the most common primary malignancy of liver and is one of the main solid tumors worldwide, being the 3 rd leading cause of cancer death. We present the case of a 20-year-old female patient operated on for sudden abdominal pain, with data on acute abdomen and hypovolemic shock, finding hemoperitoneum from a multisegmentary hemorrhagic hepatic lesion that required packing for damage control, and later, reoperation for definitive surgery and Histopathological analysis, resulting in hepatocarcinoma verified by immunohistochemistry.