Orthopedic management of the various complications resulting from musculo-skeletal bleeds in the hemophiliac, has now become standard and routine. However, the orthopedist should never minimize the threat of iatrogenic disease resulting from his surgery, or from the hemostatic control necessary for all operations. Operations should be properly indicated with standard and established techniques always being used. The development of antibodies, the risk of wound breakdown and secondary infection, and the need for further operative intervention, all create serious hazards to the hemophiliac patient. The orthopedist must be fully supported by a hematologist and laboratory back-up. Finally he should understand coagulation control and the necessity for its monitoring.