Puerperal hematomas are a rare cause of postpartum hemorrhage. Their adequate management requires expertise and an adapted technical platform. To our knowledge, no case has been published in Mali. We report the case of a 38-year-old woman, multiparous 6th procedure 5th par with 5 living children, evacuated from a community health center located 90 km away, in a state of hemorrhagic shock occurring one hour after a home birth. She was surgically treated for an expansive vulvo-perineal hematoma. This case allows us to draw the attention of practitioners to the seriousness and singularity of this highly morbid pathology.