A 52 year-old woman with systemic amyloidosis complicated with multiple myeloma died suddenly of intraperitoneal hemorrhage due to spontaneous rupture of the spleen and liver. Autopsy revealed multiple myeloma involving the bone marrow and diffuse amyloidosis involving the liver, spleen, kidneys, heart, bone marrow, lymph nodes, lungs, gastrointestinal tract, thyroid, skin and adrenal glands. The splenic red pulp and the hepatic parenchyma were replaced by masses of amyloid. Amyloid deposits were also numerous in the walls of blood vessels and linearly in the intracapsular regions of both the liver and spleen. This is the eighth case of spontaneous rupture of the spleen and the second case of spontaneous rupture of the liver in association with systemic amyloidosis.