Objective To study the perioperative treatment of the patients having fracture with hemophilia A. Methods Seven male hemophilia A patients with fractures were treated in our hospital from Jan. 1988 to Apr. 2003. All the patients received coagulation factor replacement treatment. The plasma level of factor Ⅷ was measured at preoperation, intraoperation and postoperation, fracture was treated by internal fixation, and the mean follow-up period was 16 months. Results In this series there were 1 severe, 2 moderate, 2 mild, and 2 pre-clinic hemophilia A patients, all patients had bone union during the follow-up, and no complications such as hematoma, infection and loosening or breaking of internal fixation happened. Conclusion The surgical treatment of fractures with hemophilia A can obtain excellent clinical outcome throug careful perioperative preparation.