OBJECTIVE To present a case report of severe post-partum bleeding after caesarean section and successful treatment using recombinant factor VIIa. SETTING Obstetrics and Gynecology Department, Faculty Hospital, Nitra, Slovak Republic. CASE REPORT A 29-year old secundigravida presented with major post-partum bleeding after caesarean section due to uterine atony. The patient developed hemorrhagic shock, associated with disseminated intravascular coagulation (DIC). Treatment with uterotonic drugs, prostaglandins and hysterectomy failed to control diffuse bleeding. Recombinant factor VIIa (90 microg/kg intravenous injection) was given as a final attempt to control the bleeding. The response to treatment was rapid, with control of the bleeding and resolution of the coagulopathy. CONCLUSION This case suggests a potential role of recombination factor VIIa in the treatment of severe post-partum bleeding associated with DIC.