Genital tract hematomas, although rare in both the obstetric and nonobstetric populations, can be life-threatening. The reported incidence of puerperal hematomas ranges from 1 in 300 to 1 in 1500 deliveries, with large hematomas complicating 1 in 4000 deliveries.[1] Most puerperal hematomas are vulvovaginal resulting from bleeding lacerations related to instrumented delivery or episiotomy.[2] Genital tract hematomas in the gynecologic population usually result from blunt or penetrating trauma, often accidental or sports-related, although sexual assault should always be considered.[2] There is little evidence to guide management, and options include a conservative approach, surgical intervention, or embolization. Prompt evaluation, diagnosis, and management by OB/GYN hospitalists can be key to optimizing outcomes for patients with genital tract hematomas.