Acute promyelocytic leukemia (APL) is a unique form of acute myeloblastic leukemia, which manifests by DIVC, massive hemorrhage and hypofibrinogenemia and has a rapidly fatal outcome. Here we report a case of APL in a 38-year-old woman, who presented with an acute episode of severe menorrhagia for the first time and died due to hemorrhagic complications. The diagnosis of hematological disorders including leukemia should be considered in any patient who presents with acute onset of menorrhagia with rapid deterioration and not responding to conventional treatment.