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The cause of pelvic pain remains a significant diagnostic challenge, even for experienced radiologists. An accurate differential diagnosis has to be done according to the patient's age and gender. Spontaneous round ligament hematoma is an uncommon cause of acute pelvic pain in adult female patients. To the best of our knowledge, it has never been reported in the literature in the paediatric population. Ultrasound examination is the first line imaging modality for pelvic pain evaluation in young women but it might result inconclusive. Thanks to its panoramic view and multiparametric approach, the MRI can play a pivotal role in the diagnosis of spontaneous round ligament hematoma in paediatric female patients, resulting in a more effective patient's therapeutic management., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)