Bilateral adrenal haemorrhage is a rare, potentially lethal complication that is usually occurred after major operative procedures on concomitant anticoagulation therapy. We present a case of an 83-year-old woman, who underwent a total hip replacement. On the first postoperative day she developed hypotension, abdominal pain, and fever. Laboratory tests revealed progressive hyperkalemia and hyponatremia. An abdominal computed tomography scan demonstrated bilateral adrenal haemorrhage. We examine the etiology, radiological diagnosis, and therapy of adrenal insufficiency secondary to adrenal haemorrhage.