The treatment of life-threatening post-partum haemorrhage (PPH) still remains challenging, and hysterectomy may be required to control the bleeding. Many cases of severe PPH that were treated with recombinant factor VIIa (rFVIIa) are presented. The causes of the haemorrhage and the medical and surgical interventions before rVIIa administration are briefly described. In most of these women there was a partial or good response to rFVIIa administration, while in others there was no response. Treatment with rFVIIa, in addition to standard surgical and medical interventions, may not be definitive in every patient and a selective arterial embolization may be needed.In women undergoing a subsequent selective arterial embolization, the bleeding was significantly reduced although not completely stopped. From experience with these cases, and from previously reported cases, the use of rFVIIa may be of benefit in life-threatening PPH. So hysterectomy may be avoided with the use of rfVIIa.