Spontaneous hepatic rupture is a rare but life threatening condition of pregnancy that is mostly associated with preeclampsia, eclampsia, or a HELLP syndrome. In most cases, a liver rupture occurs in the third trimester of pregnancy or within the first 24 h postpartum. It occurs more often in the multiparous women above the age of 30. In 75 % of the cases, it develops as a solitary injury of the right liver lobe, in 11 % of the left liver lobe, and a bilateral injury in 14 %. There is a wide variation in the clinical presentation and severity of the symptoms and signs of hepatic hemorrhage/rupture. Some patients present with very mild symptoms such as epigastirc pain,nausea and vomiting prior to sudden and massive circulatory collapse. If a rupture occurs during pregnancy, delivery of the fetus by caesarean section is one of the first steps. A classical Pfannenstiel incision is, however, not suitable because the entire abdominal cavity cannot be explored unless a second upper abdominal incision is made. A median laparotomy is therefore the recommended approach because it has the advantage of visualizing the entire abdominal cavity, speed of execution, and less blood loss. Surgical treatment includes liver packing, hepatorraphy, hepatic artery embolisation and liver transplantation. Due to the low incidence and high mortality rates worldwide, this condition requires clinical suspicion, diagnostic accuracy, precise timing and efficacy in therapeutic resource utilization to reduce its high mortality and to offer satisfactory results to both mother and newborn.