Spontaneous rupture of the urinary bladder (SRUB) is a rare urological emergency. It is usually secondary to an underlying pathology. An idiopathic entity has not been reported in the literature. We report a case of idiopathic SRUB in a young female presented with abdominal pain and acute renal injury in the absence of prior trauma. We have conducted a literature review to identify commonly reported etiologies. SRUB is usually secondary to an underlying pathology, but in extremely rare cases it can be idiopathic.