Paroxysmal hematoma of the fingers, or Achenbach syndrome, is a rare vascular disorder of benign course and unknown etiology. The clinical manifestations are sudden onset, paroxysmal spontaneous subcutaneous hematomas, and edema and pain in the fingers and hands. The clinical course is self-limited and does not leave permanent sequela. The diagnosis is clinical, and complementary studies are often unnecessary. We present the clinical case of a 69-year-old woman diagnosed with Achenbach syndrome in a primary care center in Colombia.