Background <p>External cephalic version (ECV) is an obstetric procedure that involves manually turning the fetus inside the pregnant woman’s abdomen to change a breech or transverse presentation to a cephalic presentation. It can significantly increase the proportion of cephalic presentations during delivery and reduce the cesarean section rate for term singleton breech presentations, making it a relatively safe operation. In this case, we report a case of fetal cephalohematoma following ECV, which has not been previously documented in the literature.</p> Case presentation <p>A 33-year-old multiparous woman with a breech presentation underwent an ECV at 39 weeks and 1&#xa0;day of gestation. Nifedipine was taken orally before the procedure to inhibit uterine contractions, and combined spinal-epidural anesthesia was performed. ECV was successful on the third attempt. On the 10th postoperative day, an ultrasound examination revealed a fetal cephalohematoma, and a cesarean section was eventually performed. The fetal cephalohematoma gradually resolved after birth, without causing severe adverse effects on the newborn.</p> Conclusion <p>ECV has few complications and can significantly reduce the cesarean section rate in breech presentations. However, during the procedure, it is important to strengthen perioperative management and improve the operator’s professional skills to reduce the risk of complications. The procedure should be performed gently, without unnecessary force.</p>