Rectus sheath haematoma (RSH) is a rare yet clinically important cause of sudden abdominal pain, stemming from bleeding within the sheath of the rectus abdominis muscle. The global incidence of RSH has been rising due to the increased use of anticoagulants and antiplatelet medications. This review aims to analyse recent findings on the epidemiology, risk factors, diagnosis, emergency management, and comprehensive nursing care for RSH patients. A narrative analytical review of existing literature was conducted, focusing on recent updates in emergency and nursing practices. RSH is responsible for about 1–2 percent of cases of acute abdominal pain. Contrast-enhanced computed tomography is the preferred diagnostic tool. Most patients who are haemodynamically stable can be managed conservatively, though embolisation is very effective for ongoing bleeding. Nurses are crucial in early detection, monitoring, ensuring anticoagulation safety, stabilising haemodynamics, and educating patients. Strengthening nursing competencies and structured escalation protocols can significantly reduce morbidity, prevent unnecessary surgical interventions, and improve patient outcomes.