Ruptured vasa previa in term pregnancy is rare but usually catastrophic if emergency delivery is not achieved. The authors present a case of ruptured vasa previa in velamentous cord insertion placenta. The fetus survived after intensive treatment immediately after delivery by cesarean section, but, unfortunately, died after the family gave him up. Defects in the vessel wall architecture were visualized and confirmed by histopathologic examination and might be responsible for the vessel rupture. Prenatal sonographic identification of cord insertion site into the placenta is encouraged as standard of practice to prevent this accident.