Recombinant factor VIIa (rFVIIa) enhances the haemostasis limited to the site of injury without systemic activation of the coagulation cascade. rFVIIa has been found to enhance thrombin generation in impaired coagulation and thrombocyta function. rFVIIa has been successfully used to treat uncontrolled nontraumatic, traumatic, surgical and thrombocytopenic bleeding. Authors present the cases of three pediatric patients, who received rFVIIa in order to reduce the uncontrolled traumatic, surgical, nontraumatic thrombocytopenic and coagulopathic bleeding. Based on the data of literature authors present the supposed, complex mechanism of rFVIIa and the experiences connected with clinical use.