Traumatic retropharyngeal hematoma is a very rare disease which occurs mainly in patients with bleeding tendency and needs early intensive management due to the potentiality of airway compromise by compression or eventual development of retropharyngeal space infection. The authors experienced a case of traumatic retropharyngeal hematoma which occurred within several hours after a fall down injury. There was no evidence of other associated injuries. The hematoma occupied the whole retropharyngeal space from the skull base down to the mediastinum with the symptoms of dyspnea and severe dysphagia. We managed the patient conservatively with absolute bed rest and prophylactic antibiotics without any procedure for airway control or surgical drainage. We report this case with the review of literatures.