Spontaneous rupture of a kidney can occur as a complication of an acquired cystic kidney lesion. Herein, one case of a spontaneous rupture of a contralateral native kidney, due to the rupture of a cystic lesion during kidney transplantation surgery, is described. The patient was a 24 year old female admitted for left kidney transplantation due to chronic renal failure. During the operation, her arterial blood pressure and central venous pressure gradually decreased after anastomosis of the renal vessel, but without significant bleeding in the operative field or any suspected cause of the decreasing arterial blood pressure. On the first postoperative day, she underwent an abdominal CT, where a retroperitoneal hematoma was found. Therefore, a right nephrectomy was performed. She also had a right perirenal hematoma due to the rupture of cystic lesion in the native kidney. While a spontaneous rupture of the kidney is very rare, especially during the perioperative period, it is important to consider this complication when evaluating the corresponding clinical picture.