Spontaneous tonsillar bleeding is a rare condition in ENT unit. Almost reported cases have been related to infection of tonsils. Prior to introduction of antibiotics, spontaneous tonsillar bleeding was usually related to superficial capsular bleeding due to acute or chronic tonsillitis. The presented case is a 36-year old healthy man without history of acute, chronic tonsillitis, and coagulation disorder who complained of dyspnea and oropharyngeal foreign body sensation after vomitting. Examination revealed a reddish polypoid mass of the right tonsil. Furthermore, the mass pushed uvula and tongue base, caused nearly total obstruction of oropharynx. All rountine laboratory test results were within normal limits. Computed tomography (CT) showed low density mass of attached in upper pole of right tonsil without enhancement. We performed tonsillectomy including the reddish polypoid mass under general anesthesia. The pathology revealed lymphoepithelial tissue with reactive hyperplasia. This is the first reported tonsillar hematoma presenting as a large oropharyngeal mass which was caused by vomitting.