Abdominal pain is a frequent complaint. In this report, a woman who presented with abdominal pain was found to have a contained rupture of the abdominal aorta that extended into the retroperitoneum. The diagnosis was difficult due to the multiple manifestations in the clinical presentation. Rupture of the aorta is more frequent in patients who suffer from an aortic aneurysm. The patient described, however, did not have an aneurysm, as illustrated by the abdominal CT scan and surgical findings. Therefore, abdominal or back pain may be caused by a rupture of the aorta, even in the absence of an aortic aneurysm.