Spontaneous rupture of the iliac vein is rare clinical emergency. Sudden onset, hypertension, and abdominal distention with a nonpulsatile mass in the iliac fossa are the chief symptoms. We reported another case of spontaneous rupture of the left external iliac vein diagnosed intra-operatively and successfully treated with direct suturing. And related literatures were reviewed. Possible etiology and optimal treatment were discussed.
 M. Yamada, M. Nonaka, N. Murai, H. Hanada, M. Aiba, M. Funami, et al., “Spontaneous Rupture of the Iliac Vein: Report of a Case,” Surgery Today, Vol. 25, No. 5, 1995, pp. 465-467. doi:10.1007/BF00311830
 B. C. Lin, R. J. Chen, J. F. Fang, K. E. Lin and Y. C. Wong, “Spontaneous Rupture of Left External Iliac Vein: Case Report and Review of the Literature,” Journal of Vascular Surgery, Vol. 24, No. 2, 1996, pp. 284-287. doi:10.1016/S0741-5214(96)70106-4
 D. Gad, M. V. Thomsen and H. G. Johannsen, “Spontaneous Rupture of the Left External Iliac Vein. A Complication of Deep Vein Thrombophlebitis?” Ugeskrift for Lager, Vol. 161, No. 48, 1999, p. 6639.
 N. Gaschignard, Y. Le Paul, T. Maouni and P. D. Le Priol, “Spontaneous Rupture of the Left Common Iliac Vein,” Annals of Vascular Surgery, Vol. 14, No. 5, 2000, pp. 517-518. doi:10.1007/s100169910096
 S. Jazayeri, E. Tatou, N. Cheynel, F. Becker, R. Brenot and M. David, “A Spontaneous Rupture of the External Iliac Vein Revealed as a Phlegmasia Cerulea Dolens with Acute Lower Limb Ischemia: Case Report and Review of the Literature,” Journal of Vascular Surgery, Vol. 35, No. 5, 2002, pp. 999-1002. doi:10.1067/mva.2002.121569
 N Kismoune, JC Eicher, S Jazayeri, F André, B Terriat, M. David, et al., “‘Spontaneous’ Rupture of the Left Iliac Vein Complicating Cockett’s Syndrome,” Archives des Maladies du Coeur et des Vaisseaux, Vol. 96, No. 4, 2003, pp. 347-350.
 Y. P. Cho, Y. H. Kim, J. Ahn, S. Choi, H. J. Jang, S. G. Lee, et al., “Successful Conservative Management for Spontaneous Rupture of Left Common Iliac Vein,” European Journal of Vascular and Endovascular Surgery, Vol. 26, No. 1, 2003, pp. 107-109. doi:10.1053/ejvs.2002.1940
 S. R. Zieber, B. R. Mustert, M. F. Knox and B. C. Fedeson, “Endovascular Repair of Spontaneous or Traumatic Iliac Vein Rupture,” Journal of Vascular and Interventional Radiology, Vol. 15, No. 8, 2004, pp. 853-856. doi:10.1097/01.RVI.0000128811.75493.CC
 H. Tannous, F. Nasrallah and M. Marjani, “Spontaneous Iliac Vein Rupture: Case Report and Comprehensive Review of the Literature,” Annals of Vascular Surgery, Vol. 20, No. 2, 2006, pp. 258-262. doi:10.1007/s10016-006-9003-5
 Y. H. Kim, S. M. Ko and H. T. Kim, “Spontaneous Rupture of the Left Common Iliac Vein Associated with MayThurner Syndrome: Successful Management with Surgery and Placement of an Endovascular Stent,” British Journal of Radiology, Vol. 80, No. 956, 2007, pp. e176-e179. doi:10.1259/bjr/69371933
 I. H. Kim, G. R. Chon, Y. S. Jo, S. B. Park and S. D. Han, “Spontaneous Left External Iliac Vein Rupture,” Journal of the Korean Surgical Society, Vol. 81, No. Suppl 1, 2011, pp. S82-S84. doi:10.4174/jkss.2011.81.Suppl1.S82