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Background: Spontaneous renal hemorrhage is relatively uncommon but may be life- threatening. There are some challenges in early diagnosis due to the lack of specific presentations Case: We reported a case of A 45-year-old female presented with chief complaints of pain in right flank for 2 days. The pain was sudden in onset, severe, progressive and relieved by taking analgesics. On examination, vitals were stable. Tenderness and guarding were present in right renal angle with rest of the abdomen normal. Patient was shifted to ICU for observation and started on antibiotics, analgesics and antacids. USG Abdomen, CT Renal Angiography, MRI Abdomen were done. Diagnosis of perinephric haematoma was made. Patient was managed conservatively with close observation in view of normal vitals and was discharged in a stable condition after 12 days of uneventful stay in the hospital. She followed up twice in the OPD in a stable condition. Conclusion: We believe conservative management should be tried in cases where aetiology is not clear, failure of which should follow surgical intervention in the form of evacuation of haemorrhage. [ABSTRACT FROM AUTHOR]