Case presentation: We report a case of a 24-year-old African woman who was gravida 2 para 1 with no living child. who underwent an emergency caesarean section due to placenta previa at 37 weeks + 5 days. She gave birth to a male baby weighing 2.7 kg and had an Apgar score of 8 and 10 in 1st and 5th minute respectively. She sustained postpartum hemorrhage and anemia which was further complicated by gross hematuria post-delivery. After several days of conservative management with bladder irrigation and blood transfusions, she recovered and was discharged home; passing clear urine. Conclusion: Hematuria in puerperium can cause diagnostic dilemma to the obstetricians and has the potential of causing morbidity to patient.