&NA;A post‐traumatic hematoma may present either acutely as a presacral collection or chronically as a retrorectal mass. A case of postpartum presacral hematoma and its management in the acute setting is described. A case of a chronic, calcified hematoma presenting as an asymptomatic retrorectal mass is also reported. CT scanning of the presacral space is the most accurate means of preoperative diagnosis. Therapy must be tailored to the preoperative diagnosis and to the size of the lesion.