<p>Spontaneous abdominal hemorrhage (SAH) refers to acute intra-abdominal or pelvic hemorrhages occurring from non-traumatic or non-iatrogenic causes. Early recognition of SAH with prompt surgical or interventional management is necessary to prevent morbidity and mortality. The initial clinical presentations are often misleading, and the diagnosis is generally made based on radiological imaging. In this article, we discuss the anatomy of abdominal and pelvic compartments, etiology/pathogenesis, and characteristic imaging findings of spontaneous hemorrhage in each of these compartments, thus aiding the radiologist to make a prompt diagnosis, to direct clinical management and facilitate patient care.</p> Graphical Abstract <p></p>