We report a very rare case of intra-peritoneal spontaneous rupture of the urinary bladder which was successfully managed conservatively in a 77-year-old woman, who presented with lower abdominal pain, acute urinary retention and pelvic organ prolapse (POP). Computed tomography raised the suspicion of bladder rupture which was later confirmed by cystoscopy and cystogram. Following 8 weeks of urinary catheterisation, the bladder healed spontaneously. A subsequent sub-total abdominal hysterectomy and sacrocervicopexy were performed to treat the POP. The management of bladder rupture is discussed.