We report the case of a 23-year-old woman admitted for a haemoperitoneum secondary to the rupture of an ovarian endometrioid cyst. Preoperative investigations revealed the diagnosis of acute myeloid leukaemia of M3 type complicated by severe thrombocytopenia. The patient eventually died of intracerebral haemorrhage.The rarety of acute abdomen by bleeding as the first sign of acute leukaemia is emphasized.