Advanced liver disease is associated with several haemostatic alterations which can lead to either thrombosis or bleeding complications. Spontaneous muscle haematomas although a rare complication of liver cirrhosis is increasingly being described in the literature and hyperfibrinolysis is an emerging plausible pathophysiological mechanism. We describe a patient who presented with a life threatening spontaneous haematoma in his gastrocnemius muscle that required treatment with antifibrinolytic therapy to control further bleeding.