We report splenic rupture a few hours after a colonoscopy. Even though the patient had no previous history of splenic injury or symptoms attributable to splenocolonic adhesions, exploration revealed adhesions between the spleen and the colon at the level of the splenic flexure. Pathological examination revealed capsular thickening and fibrosis. Splenocolonic adhesions may lead to potentially lethal rupture of the spleen. A careful history prior to endoscopy should rule out pathological conditions that may lead to formation of adhesions between the spleen and the colon. In addition, the endoscopist should consider splenic rupture after colonoscopy in the patient who develops abdominal pain and acute anemia without evidence of intestinal perforation or external bleeding.