A 34-year-old woman with a history of acute alcoholic pancreatitis presented with complaints of epigastric pain, nausea, and vomiting. Abdominal/pelvic CT revealed a massive pseudocyst within the left side of the abdomen, anterior to the body and tail of the pancreas, measuring 20 × 12 × 15 cm. Repeat CT showed spontaneous rupture of a pseudocyst into the peritoneum with pancreatic ascites, which was treated with surgical lavage and supportive care. Her symptoms improved slowly over 2 weeks with conservative management, and she was discharged home with the subsequent resolution of her skin lesions a week later.