Introduction. Hemophilic arthropathy and the subsequent development of osteoarthritis in the large foot joints often require surgical intervention. At the same time, the course of hemophilia and the need to correct blood clotting factors make it diffi cult to manage the patient. The lack of awareness of the operating surgeon can serve as a reason for refusing the operation.Aim — to present a clinical case of hemophilic arthropathy of the subtalar joint in a patient with hemophilia B who underwent fusion.Main findings. The observation demonstrates the complexity of perioperative management and the need for the selection and correction of individual factor replacement therapy. A clinical case may be of interest to trauma surgeons, orthopedists, as well as clinical pharmacologists working in surgical hospitals.