Background: Angina bullosa hemorrhagica (ABH) is a rare, benign oral condition characterized by sudden-onset blood-filled blisters, typically on the soft palate, which rupture spontaneously without scarring. Despite its benign nature, ABH is often misdiagnosed as more serious vesiculobullous or hematologic disorders.

Case Presentation: A 49-year-old female presented with a painful choking sensation after having dinner. Examination revealed a ruptured hemorrhagic bulla (1 × 1 cm) on the left posterior soft palate. Systemic causes were excluded via normal hematological tests (CBC, coagulation profile). The lesion healed within 3 weeks with conservative topical management.

Conclusion: ABH is a clinical diagnosis requiring no invasive interventions. This case underscores the importance of distinguishing ABH from pemphigus vulgaris and hematologic disorders to avoid unnecessary treatments. Patient education on trauma prevention is key to reducing recurrence.

Keywords: Angina bullosa hemorrhagica; Oral hemorrhagic blister; Pemphigus vulgaris mimic; Conservative management