Background: Ovarian cysts are usually treated using medical or surgical interventions. However, in some cases, these treatments may not be feasible or effective, and alternative options need to be considered. Case presentation: We report a case of a 43-year-old woman with a history of recurrent hemorrhagic ovarian cysts, who was on anticoagulant therapy due to tight mitral stenosis and had multiple autoimmune disorders. Surgical castration was not a viable option due to the bleeding risk, and intramuscular injection of analogues was not preferred. Therefore, external ovarian radiotherapy for hemostasis was planned. Conclusion: Our case highlights that external ovarian radiotherapy can be an effective option for hemostasis in patients with bleeding ovarian cysts, especially when other treatments are contraindicated or have failed.

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