Non-traumatic hemoperitoneum is a finding requiring prompt diagnosis and intervention due to its non-specific symptoms and potential severity; it can arise spontaneously or iatrogenically, with causes including vascular neoplasms, arterial lesions, anticoagulation therapy, spontaneous spleen rupture, and gynaecological conditions. Imaging typically first involves ultrasonography, to identify hemoperitoneum, but CT with intravenous contrast is the gold standard, offering a better sensitivity and specificity. CT protocols may vary, but generally involve multiphase scans with bolus tracking to identify active bleeding; Dual Energy CT provides advanced imaging capabilities, reducing the need for multiple phases and radiation exposure. CT findings of hemoperitoneum include intraperitoneal fluid varying in density, and signs such as the “sentinel clot sign” and the “haematocrit effect.” Bleeding of hepatic origin is often due to ruptured hypervascular neoplasms, while splenic rupture can result from underlying pathology such as infections or hematologic disorders. Visceral artery abnormalities, including aneurysms and pseudoaneurysms, are significant non-traumatic bleeding sources, often requiring CT angiography for diagnosis and endovascular intervention for treatment. Angiography plays a critical role in managing hemodynamically stable patients with active bleeding mainly through transcatheter arterial embolization and Cone-Beam CT for a precise intervention.