Contralateral formation and expansion of hemorrhagic contusion is a significant and rare complication following decompressive craniectomy. Decompressive craniectomy is an important surgical tool for management of raised intracranial hypertension secondary to various pathologies including trauma. These uncommon events are reported in the literature along substantive explanations and theories. We present two cases of road traffic accident (RTA) who following decompressive craniectomy developed expansion of contralateral hematoma. In this article, we are focus on the appearance and expansion of contralateral intraparenchymal contusion following decompressive craniectomy with a deep dive into the existing literature.