Lower limb haematomas caused by trauma are debilitating wounds for the elderly who are most at risk. Prompt action needs to be taken to stop the bleeding and reduce the extent of tissue damage and skin loss. Literature on the management of lower leg haematoma is sparse compared to the management of skin tears, and there may be debate regarding surgical versus conservative approach. Many patients are not suitable for surgery due to underlying comorbidities, frailty and anaesthetic risk. Conservative management should support early evacuation of the haematoma and application of compression bandaging, avoiding lengthy hospital stays and enabling patients to be managed in the community setting.