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Acute coronary syndromes are uncommon the in postpartum period, and are usually related to spontaneous coronary dissections or intramural hematomata.However, the realfrequency may be under-estimated because of lack of early diagnosis.The combination of multiple imaging modalities could increase the recognition of this disease and provide a clue for a better understanding of the postpartum ischemic heart disease.We report two cases of spontaneous intramural coronary hematoma occurring in the postpartum period, which were recognized by multi-modality imaging combining CT angiogram, coronary angiogram, optical coherence tomography (OCT) and intravascular ultrasound (IVUS).