Adrenal cortical carcinoma (ACC), a rare and highly malignant neoplasm of the cortical tract of the adrenal gland, is usually diagnosed at an advanced stage of development and often when metastatic spread already has begun. We report a very rare case of low-stage, non-metastasized ACC, the first clinical appearance of which was a large retroperitoneal hemorrhage caused by the rupture of the neoplastic mass. To the best of our knowledge, this is the third reported case of ACC rupture.