Background: Rectus sheath hematoma (RSH) results from the accumulation of blood in the rectus sheath. It is often self-limiting but might be fatal sometimes. The aim of this study was to present two patients with RSH post-laparoscopic cholecystectomy (LC) who were managed expectantly with a long length of stay and blood transfusion. Case Presentation: Two females (47 and 52 years old) had undergone LC and developed RSH on postoperative days 1 and 3, respectively. Both were anemic and slightly tachycardic, with no other abnormalities. RSH was diagnosed in both cases with sizes 5.52 × 3.62 cm and 2.7 × 1.4 cm, respectively, shown on ultrasonography and CT scan of abdomen. The patients were treated conservatively, with blood transfusion. The patients were then discharged. Conclusion: RSH might develop post-LC; hence, surgeons should assess the patient’s complaints, labs, and physical examination to find RSH.

Keywords: Rectus sheath hematoma, surgery, laparoscopy cholecystectomy, case report