A renal angiomyolipoma (AML) is an unusual benign tumor that is composed of adipose tissue, smooth muscle, and abnormal blood vessels. AMLs can occur sporadically or can be associated with tuberous sclerosis. A ruptured renal AML may manifest as lift-threatening hypovolemic shock or sudden death. Herein, the authors present an autopsy case of traumatic rupture of a renal AML in a patient with tuberous sclerosis.