Background: Vulvar hematomas may be caused by obstetric, athletic or sexual trauma or by car or bicycle accidents.
Case: A 29-year-old woman presented with a serious vulvar hematoma caused by a straddle bicycle accident. Monitoring of the hematologic parameters showed progressive anemia resulting from silent bleeding, which required surgical evacuation of the hematoma and complete hemostasis.
Conclusion: The rich vulvar vascular network may be easily damaged by contusive frontal impacts, which crush the vulvar tissues against the osseous planes. Management of vulvar hematomas may range from conservative to surgical. Drainage and incision are advised in more severe cases to reduce infective complications and hospitalization.