A healthy 66-year-old man with no previous medical history was admitted to the ED for a first episode of rapid onset severe epigastric pain. It appeared at rest without associated symptoms such as dyspnea or vomiting. He reported taking non-steroidal anti-inflammatories for 1 week prior to admission for an epicondylitis. On admission, his pain had rapidly subsided and the physical examination was inconclusive: blood pressure, temperature, heart rate, and capillary filling were normal. Thoracic auscultation and abdominal palpation revealed only slight epigastric pain. ECG and troponin assay were normal as was hemoglobin, bilirubin, liver enzymes, and lipase levels. As a part of our department’s policy, a POCUS was performed essentially to rule out cholelithiasis. It was performed using a Philips CX50 with a 3.5–5 MHz abdominal probe. There were no gallstones; however, POCUS revealed a mass located between the spleen and the left kidney measuring 80 * 74 mm. The mass was vascular with a strong color Doppler signal and an intraluminal thrombus which explains why the Doppler signal does not fill all the lumen. The maximum velocity in the aneurysm was only 18 cm/s because of the large diameter. The aorta was explored from diaphragm to bifurcation. No other aneurysm was found. Small amounts of free peritoneal fluid were detected around the spleen. Urgent computed tomography diagnosed a fissurated giant aneurysm of the splenic artery. A selective angiography was then performed under general anesthesia; a complete exclusion of the aneurysm was obtained with glue/lipiodol embolization. The post-intervention course was uneventful and the patient was discharged home 3 days later. The patient has remained free from any complications of the embolization 6 months after the procedure.