Spontaneous kidney rupture (SKR) is a rare, life-threatening condition that can be challenging to diagnose, particularly in individuals without prior renal pathology. We report a case of a 49-year-old male bodybuilder who experienced sudden left flank pain during weightlifting. CT imaging revealed a massive left retroperitoneal hematoma and grade III renal trauma. The patient had no medical history but admitted to anabolic steroid use. He was initially managed conservatively but required selective angioembolization. He fully recovered and was discharged nine days later. This case highlights SKR's rare presentation in a healthy individual, potentially triggered by extreme physical exertion.

© 2025 The Authors. Published by Elsevier Inc.