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ANN SAUDI MED 2016 NOVEMBER-DECEMBER WWW.ANNSAUDIMED.NET 440 Spontaneous rupture of uterus during pregnancy is a rare occurrence.1,2 The diagnosis is not always obvious and morbidity and maternal and fetal mortality is high.3 We report an unusual case of spontaneous uterine rupture at term with fetal death which was confused on ultrasound with placenta praevia, the diagnosis of rupture being confirmed on CT scan. A 24-year-old primigravida presented at 37 weeks gestation with complaints of gradually increasing pain in her right lower abdomen and vomiting for 3 days and mild vaginal bleeding for one day. She also had complained of decreased fetal movements for one CT diagnosis of spontaneous uterine rupture at term, sonographic appearance of which was confused with placenta praevia