We report a patient with tetralogy of Fallot who developed spontaneous bilateral perirenal hematoma at the age of 35. Polycythemia was seen from the age of 3 in this patient. Prolonged clotting time and partial thromboplastin time were observed on various occasions before he developed perirenal hematoma. Blood letting was done periodically according to the value of hemoglobin level and packed cell volume. Resolution of hematoma was seen sonographically.