Aim: In this study,we aim to present the clinical features of patients with Rectus Sheath Hematoma (RSH), therapeutic management and results. Methods: The study included patients who were diagnosed with and received treatment due to spontaneous rectus sheath hematoma between the years 2010 and 2020. The demographic and clinical features of the patients,history of anticoagulant drug use and indication for anticoagulant drugs, laboratory parameters and radiological findings at the time of admission to the hospital, diameter of the hematoma, treatment modalities, follow-up parameters were analyzed retrospectively. Results: Our study included fifty-three patients. The median age was 65.7±14,68 years and 63.3% of the patients were over the age of 65 years. Number of female patients was 35. Cases most often had an American Society of Anesthesiologists score of 3 (64.3%). The most frequently used anticoagulant was warfarin (30.1%) and it was most often used due to heart diseases (54.7%).International Normalized Ratio value at the time of admission to the hospital was 1.93+1.18 and the hemoglobin value was 11.2 gr/dl. Average hematoma diameter was 74 mm and the most common stage was Type 1 (75.6%). 90.6% of the patients were followed up conservatively. Average duration of hospital stay being 15.1 days, mortality developed in 8 patients during their hospital stay. Conclusion: Spontaneous RSH should come to mind in elderly female patients who apply to the hospital with acute abdominal pain and are on anticoagulant therapy. Suspecting RSH can render early and true diagnosis possible, thus reducing morbidity and mortality in these patients.