Spontaneous tonsillar hemorrhage (STH) is a rare occurrence, and mainly occurs as a complication of acute tonsillitis. We report a case of peritonsillar abscess accompanied by STH. The patient presented with oral hemorrhage and dyspnea. Computed tomography revealed air density around the tonsils on both sides. In this case, the tonsillar bleeding did not need any intervention, and the peritonsillar abscess was successfully treated by incision and drainage and antibiotic plus steroid administration. STH should be managed by appropriate control of bleeding and prompt treatment of the tonsillar inflammation.
