Oesophageal intramural haematoma is an uncommon form of oesophageal injury. Oesophageal intramural haematoma can occur spontaneously without any preceding events. This report is of two patients who presented with haemoptysis and were incidentally found to have spontaneous oesophageal intramural haematoma by computed tomography. The diagnoses were confirmed by endoscopy and both patients were treated conservatively and had complete resolution confirmed by follow-up imaging and endoscopic examination. The typical clinical findings of central chest pain, dysphagia or odynophagia, and haematemesis, are nonspecific and could mimic a wide variety of conditions. Correct diagnosis can be made with clinical history and characteristic computed tomography findings. Although spontaneous oesophageal intramural haematoma is uncommon and presentation with haemoptysis is not typical, radiologists and clinicians should not overlook this condition as a differential diagnosis.