Although there have been a few case reports of spontaneous rupture of pelvic veins, such as the iliac vein, to date, there have been no reports of spontaneous rupture of the ascending lumbar vein. Here, we report a case of spontaneous rupture of the ascending lumbar vein for the first time. A 66-year-old woman visited the emergency department due to the swelling of the left lower limb for 2 hours. After admission, the patient developed symptoms of pain in the left lumbar region, as well as symptoms of shock, such as increased heart rate and decreased blood pressure. During emergency venography, it was found that the ascending lumbar vein was ruptured, which was accompanied by the compression and occlusion of the iliac vein (May-Thurner syndrome). During the endovascular surgical treatment, a covered stent was placed in the iliac vein, and the occluded common iliac vein was treated with a bare stent. Immediately after the surgical procedure, the patient's abdominal computed tomography examination showed the formation of a large retroperitoneal haematoma, and continuous routine blood parameter monitoring showed that haemoglobin was stable. Postoperative recovery was uneventful, and the patient was discharged on the ninth postoperative day.