Acute massive haemopneumothorax is frequently related to open or blunt chest trauma, whereas spontaneous haemopneumothorax is rare and may be due to multiple hereditary exostosis (MHE). We report a case of acute massive spontaneous and relapsed haemopneumothorax occurring during a volleyball match, and caused by solitary costal exostosis. Thoracoscopy failed to disclose and remove the cause of the haemopneumothorax and so the patient underwent thoracotomy for costal resection and lung parenchyma suture.