BACKGROUND AND PURPOSE Ultrasound (US) is one of the most common modalities used in intervention for musculoskeletal disorders, although its effectiveness is debated. The purpose of this case report is to describe the intervention, including the use of US, in the management of a large rectus sheath hematoma (RSH) in a patient receiving anticoagulant therapy. CASE DESCRIPTION The patient was a 62-year-old woman with RSH who was receiving oral anticoagulant therapy and had a history of bouts of coughing. Computed tomographic scans verified the diagnosis of RSH. The report describes the patient examination, management, intervention, and outcomes. OUTCOMES The intervention, including the use of US therapy, may have enabled a rapid resolution of the hematoma. DISCUSSION This case report illustrates how US may be a useful modality for complementary management of RSH, helping the reabsorption of the hematoma.