Complex medical, psychological and social factors affect how patients with haemophilia and their families respond to bleeding episodes. Prompt, adequate treatment for bleeds remains the best way to preserve optimal musculoskeletal health. Untreated and under treated bleeding episodes into muscles and joints can cause pain, deformity and severely limit the daily activities of patients with haemophilia. Viral infections over the last decade have, to some extent, diverted attention away from musculoskeletal problems. The orthopaedic contribution to haemophilia care remains important and can be enhanced through regular review clinics and developing focused approaches to identifying and addressing musculoskeletal problems.