Abstract The severe and progressive permanent crippling defects that develop in the child with severe hemophilia are no longer inevitable. Although the prophylactic administration of deficient factor on a daily basis by intravenous injection to the young child suffering from hemophilia is economically and logistically prohibitive in most instances, the immediate administration of deficient factor at the onset of an acute bleeding episode will retard, if not totally prevent, the development of hemophilic arthritis. A continuous program of physical therapy for muscle strengthening increases the support of joints, improves coordination, and tends to lessen the number of bleeding episodes. It must be recognized that although deficient factor replacement, physical therapy, and other orthopedic measures are of utmost importance, optimal care of the child with hemophilia must also include attention to the social and psychological complications of this disease. The provision for a normal home and school experience, adequate participation in physical activities, and the use of appropriate disciplinary measures will allow the child with hemophilia to reach adulthood with a minimum of emotional and physical disability.