We describe a rare case of secondary amyloidosis associated with usual interstitial pneumonia (UIP), who died from spontaneous rupture of the amyloid spleen. A 68-year-old man was admitted to evaluate to his interstital lung disease. Chest radiography showed reticular shadow in bilateral lower lung fields. Two years later, he suddenly felt severe abdominal pain. In spite of maximum therapy, he died from hypovolemic shock. Postmortem examination revealed massive intraabdominal hemorrhage. The diagnosis of lung disease was UIP and amyloid A type deposits were observed in various organs including the ruptured spleen.