A 67-year-old female developed an endocapsular hyphema after uncomplicated extracapsular cataract surgery. With a neodymium:YAG laser capsulotomy, we drained the blood into the vitreous and restored excellent visual acuity. We hypothesize that endocapsular hyphemas may fail to resorb because of sequestration of the clot from the fibrinolytic system of the anterior chamber.