Endoscopy of both the upper and lower gastrointestinal tract remains one of the commonest procedures performed on patients. The common risk factors associated with this procedure are well known. However, some of the rarer complications are not known or are not considered in the immediate postprocedure time period when a patient experiences acute abdominal pain. Herein, we report a case of solid organ injury (splenic capsular tear) resulting from endoscopic retrograde cholangiopancreatography. The risk factors and presentation of this type of injury are reviewed, including its association with chronic pancreatitis, which we describe for the first time.