Metastatic squamous cell carcinoma (SCC) in the spleen is a rare malignant tumor primarily originating from areas covered by squamous epithelium. The present study reports the case of a 58-year-old man who had undergone a radical gastrectomy for gastric SCC and a subtotal splenectomy for anemia previously, and who now presented with abdominal pain. On presentation to the Emergency Department of Shaoxing Second Hospital (Shaoxing, China), a bedside emergency ultrasound (US) examination was performed, which revealed a mass mimicking a splenic abscess in the residual spleen. After ineffective anti-inflammatory treatment, a bedside US-guided biopsy was performed for subsequent treatment and confirmed the diagnosis of metastatic SCC in the residual spleen. Point-of-care US is the first-line imaging choice for patients with abdominal pain, as it can identify several pathological conditions. The present case shows that point-of-care US combined with bedside US-guided biopsy can be used to clarify the diagnosis.