Pyometra is the accumulation of purulent material in the endometrial cavity. It is an uncommon condition in postmenopausal women that can lead to uterine rupture, a complication with high mortality if not treated promptly. Imaging studies, particularly computed tomography (CT), play a fundamental role in diagnosing this condition and excluding more common pathologies. We present the case of an 86-year-old female patient with an acute abdomen secondary to uterine rupture due to pyometra diagnosed via CT.