Intra-abdominal haemorrhage in horses can be due to rupture of the spleen and may result in severe blood loss. The assessment and resuscitation of a foal that collapsed due to intra-abdominal haemorrhage is presented. Diagnosis of the source of the blood loss required exploratory laparotomy and confirmed splenic capsular rupture and haemorrhage. Splenectomy using a 17th rib resection approach was used to control the haemorrhage. Complications included acute cardiac muscle damage, which was monitored using echocardiography and troponin I levels. The successful surgical management of the ongoing blood loss in this foal suggests that splenectomy should be considered an option to control severe blood loss due to splenic rupture.