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Puerperal hematomas may be associated with significant hemorrhage, both immediately after delivery and later in the postpartum course. The incidence of puerperal hematoma ranges from 1 in 300 to 1 in 1,000 deliveries. Puerperal hematomas may be classified as vulvar, vulvovaginal, paravaginal, or retroperitoneal. The most common factor associated with puerperal hematomas is an episiotomy. Indeed, hematomas may develop following rupture of a blood vessel without laceration of the superficial tissues. Retroperitoneal hematomas rarely complicate vaginal deliveries. Retroperitoneal hematomas may be associated with branches of the uterine artery or other vascular structures within the broad ligament. Retroperitoneal hematomas are the most difficult hematomas to diagnose. Retroperitoneal hematomas are more difficult to treat because of difficult surgical access. We report a rare case involving a retroperitoneal hematoma without a vaginal wall laceration followed by a normal vaginal delivery, with a review of the relevant literature.