Background: Accidental haemorrhage (abruptio placentae) is a significant obstetric complication contributing to maternal and perinatal morbidity and mortality. This study aimed to assess the prevalence and risk factors of accidental haemorrhage among women admitted to Dhaka Medical College Hospital. Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh, from July 2002 to June 2003. This study included 50 cases of accidental haemorrhage among 9,078 obstetric admissions at Dhaka Medical College Hospital. Results: The incidence of accidental haemorrhage was 0.91%. Most patients were aged 20–29 years (68.0%) and from a low socioeconomic background (76.0%). Parity distribution revealed that 48.0% had parity of four or more. Clinically, 40.0% of patients presented with a pulse rate between 90–110 bpm, and the most common systolic blood pressure was 80 mmHg (40.0%). Anaemia was moderate in 40.0% of patients, and the majority (52.0%) had haemoglobin levels between 51–60%. A significant proportion (40.0%) received no antenatal care. Mixed-type haemorrhage was the most common presentation (50.0%), while Grade II haemorrhage predominated (44.0%). Preeclamptic toxaemia with pregnancy-induced hypertension was identified as the leading risk factor (50.0%). Conclusion: Accidental haemorrhage remains an important clinical challenge in obstetrics, particularly among multiparous women with low socioeconomic status and inadequate antenatal care. Early detection and comprehensive antenatal screening are essential to reduce morbidity and mitigate risk factors.