Small cell carcinoma of the cervix (SCCC) is a rare disease, accounting for fewer than 3% of all cervical neoplasms. However, SCCC is an extremely aggressive tumor that is usually not confined to the cervix at the time of diagnosis. Unlike other carcinomas of the cervix, early-stage SCCC cannot be reliably detected by Papanicolaou smear. The initial presentation is usually non-specific, and often presents with abnormal vaginal bleeding. In this report, the case of a patient with SCCC presenting to the Emergency Department is described to better inform emergency physicians of the existence of this condition. Based on a review of the literature, an update on clinical presentation, diagnosis, and therapeutic options is provided.