Introduction: A rare case of adrenal myelolipoma presenting with spontaneous rupture and retroperitoneal haemorrhage is described. Clinical Picture: A 51-year-old Caucasian male presented with acute onset of right loin pain. Preliminary diagnosis of haemorrhagic adrenal tumour was made on computed tomography (CT) and angiography. Treatment: Vascular embolisation was performed to stabilise the patient prior to definitive surgery. Tumour resection was subsequently performed. Histology confirmed ruptured adrenal myelolipoma. Outcome: The patient made an uneventful recovery. Conclusion: Ruptured adrenal myelolipoma should be considered in cases of spontaneous retroperitoneal haemorrhage. Vascular embolisation may be useful in stabilising the patient prior to definitive surgery.