Introduction: Ruptured renal angiomyolipoma (AML) is a life-threatening condition that may mimic other diagnoses in the clinical presentation, and if not diagnosed promptly, it can lead to life-threatening bleeding and shock. Case Report: In this article, we report the case of a 56-year-old previously healthy Saudi man who presented with isolated left flank pain. The patient was initially treated as a case of renal colic, possibly caused by renal stones. However, the imaging revealed the clinical picture to be caused by a ruptured renal AML of the left kidney and successfully treated with angiographic embolization by an interventional radiologist. Conclusion: Despite its rare occurrence, rupture of the renal AML may mimic other diagnoses and lead to life-threatening hemorrhagic shock. Prompt diagnosis and management can improve outcomes. By reporting this case, we want to highlight the importance of considering alternative differential diagnoses and including all the substantial life-threatening conditions while dealing with patients presenting with isolated flank pain, even with no other risk factor.
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