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OBJECTIVE To describe a case of spontaneous hemoperitoneum in a woman affected by deep infiltrating endometriosis (DIE). DESIGN Technical video showing laparoscopic management of a spontaneous hemoperitoneum in a patient with DIE. SETTING Minimally Invasive Gynecological Unit, Sant'Orsola Academic Hospital, Bologna, Italy. INTERVENTION A 35 years old nulliparous woman was admitted to our gynecological emergency room due to pelvic pain and fainting sensation. She had a history of DIE and she has been followed for six months by our outpatient clinics. The patient necessitated an immediate recovery in the operating room for laparoscopy, due to the rapid worsening of clinical conditions. After blood suction and difficult adhesiolysis, a vascular lesion with huge blood flow, close to the left utero-ovarian ligament, was detected. A selective coagulation was performed with good results. During follow up visit after one month, the patient reported good health conditions. Written informed consent was obtained from the patient for publication of this case report. CONCLUSION Spontaneous hemoperitoneum represents a rare and life-threatening complication associated with endometriosis. In patients with hemoperitoneum and a history of endometriosis is important to pay attention to the possible presence of uncommon bleeding localizations. Laparoscopy was useful and effective in this challenging situation, identifying the bleeding source and performing a selective coagulation.