Splenic rupture due to trauma is relatively common. However, spontaneous non-traumatic ruptures do occur. Causes include infection, neoplasia and infiltrative process. We present an unique case of a 59-year-old patient who presented with dyspnea and left upper abdominal discomfort following bouts of coughing, and was provisionally diagnosed as pulmonary embolism. CT scan revealed splenic rupture. Only a few case reports are published documenting spontaneous splenic rupture following coughing. The therapy of choice can vary between patients depending on the grade of splenic rupture, hemodynamic instability, availability of endovascular treatment and physician preference. Treatment should be focused on preserving splenic tissue if feasible. Non-traumatic rupture of the spleen must be considered in patients presenting with left-sided upper abdominal pain even without evident history of trauma, since early recognition and treatment can prevent serious morbidity and mortality.