Medical science has witnessed significant progress in the development of hemostatic materials, which save lives by supporting natural hemostatic ability. However, for the hemostasis under coagulopathy where natural hemostatic ability is dysfunctional, many conventional hemostatic materials are ineffective. Recent advances in hemostatic materials, including fibrin, chitosan, gelatin, nanoparticles, PEG derivatives, elaborate liposomes, oxidized cellulose, and fibrinogen-specific binding polymers, have led to significant success in tackling bleeding in coagulopathy. In this review, we present a thorough analysis on the hemostatic mechanisms and the design principles of hemostatic materials for coagulopathy, survey their remarkable success, and briefly discuss the challenges and perspectives for their clinical translation.