Splenic rupture is one of the most frequent trauma-related injuries in the general population. While splenic injury is uncommon in pregnant patients, trauma is the leading non-obstetric cause of maternal death and is associated with significant maternal and fetal morbidity and mortality. The most frequent and life-threatening cause of trauma in this population is road traffic accidents. This article describes the case of a 32-week-pregnant patient who was involved in a car accident. She sustained a grade V splenic injury and a grade III left kidney injury, according to the classifications of the American Association for the Surgery of Trauma (AAST). The patient underwent laparotomy, an emergency cesarean section resulting in the delivery of a live-born female, and splenectomy. The renal injury was treated conservatively. The fetus required intensive care immediately after birth. The diagnostic approach, even during pregnancy, must address not only the uterus but also other potential injuries, which may lead to severe hemorrhage, shock, and possible maternal and fetal death. A multidisciplinary approach is essential to ensure the best outcomes for both mother and fetus.