Hemophilias are a group of hereditary bleeding disorders caused by deficiency and / or defective one of the coagulation factors. Cessation of blood loss (homeostasis) is achieved by clot formation which is simultanuasly opposed by fibrinolysis which limit the clot formation to the site of injury. Clot formation needs functioning endothelium, platelets of adequate number and function and sufficient coagulation factors. When a vessel is cut or ruptured the following occur vascular spasm to decrease blood loss, formation of platelets plug in 3 events adhesion, activation and release of granular content and aggregation. The coagulation phase of homeostasis consists of a sequential series of complex reaction in the form of cascade in which many plasma coagulation proteins & clotting factors are involved. Traditionally the coagulation system is divided into an intrinsic and extrinsic pathways converting to common pathway at the point where factor X is activated. The intrinsic and the extrinsic pathways are not entirely distinct in vivo, but considering them as separate pathways facilitates the understanding of the events of the coagulation. There is 3 types of haemophilia : (1) Haemophilia A which is X-linked recessive haemorrhagic disorders characterised by excessive bleeding into various parts of the body soft tissue haemotomas & hemarthrosis leading to severe, crippling haemoarthropathy are highly characteristics of the disease. The disease has been broadly classified as mild, moderate and severe although there is overlap between categories.Patients with haemophilia A characteristically have a prolonged activated partial thromboplastin time. (the prothrombin, thrombin-clotting time, & bleeding time are normal.). But a definitive diagnosis of haemophilia A should be based on a specific assay for factor VIII activity. Management of hemophilia A includes avoidance of drugs interfere with platelets aggregation, factor VIII replacement, desmopressin, antifibrinolytic agents fibrin glue, liver transplantation & gene therapy. Complication of treatment of hemophilia A include factor VIII inhibitors and infectious complications.Haemophilia B is inherited as & clinically indistinguishable from haemophilia A characterized by a decrease in factor IX. Haemophilia C is inherited as autosomal dominant due to deficiency of factor XI. Anaesthetic management of hemophilic patient needs pre-operative correction of the causing coagulation factor. Regional anesthesia is not preferred. During anesthesia we should avoid airway trauma, and infection by AIDS. Put in consideration coexisting liver disease . Blood transfusion is mandatory in the form of whole blood, packed RBC's, fresh frozen plasma, platelets or cryoprecipitate. Massive blood transfusion may be needed and we should take care of its complications.