Abstract A neonatal Holstein bull calf presented emergently for abdominal evisceration. Calving was unassisted. Ninety minutes postpartum, farm staff noted the defect and brought the patient to the hospital. On presentation, the calf was recumbent, dull, and in hypovolemic shock with uncompensated hyperlactatemic metabolic acidosis. Multiple organs were identified through a 4–5 cm defect in the caudoventral midline. Differentials included a ruptured omphalocele, gastroschisis, trauma and schistosomus reflexus. This presentation was consistent with a ruptured omphalocele. Following triage and haemodynamic stabilisation, the eviscerated abdominal contents were lavaged, surgically replaced and an umbilical resection with partial cystectomy performed to remove a patent urachus. Postoperatively, the patient was hospitalised with aggressive nursing care. Pharmacotherapy included prophylactic antibiotics, gastroprotectants and anti‐inflammatory medication. The calf developed mild postoperative pneumonia, but was discharged after 6 days. This report details management of omphalocele evisceration in a calf and the pathology of congenital midline anomalies in neonatal ruminants.