Hemophilia A is an X-linked recessive disorder characterized by a deficiency of coagulation factor Ⅷ(FⅧ) and therefore by a greater risk of bleeding during percutaneous interventional procedures and during the dual antiplatelet therapy(DAPT) in patients with ischemic heart disease. Information regarding safe percutaneous procedures in hemophiliacs is limited. Since the introduction of FVⅧ concentrates, the life expectancy of hemophiliac patients has improved and consequently, the rate of ischemic heart disease in this population is increased. Frequently the replacement therapy can trigger the onset of an acute coronary syndrome. We report a case of a patient with mild Hemophilia A, who presents with unstable angina, treated successfully with coronary angioplasty and drug eluting stent implantation without replacement of FVⅧ, treated with long term DAPT without major bleeding after six months of follow up. Hemophilia A is an X-linked recessive disorder characterized by a deficiency of coagulation factor VIII (FⅧ) and therefore by a greater risk of bleeding during percutaneous interventional procedures and during the dual antiplatelet therapy (DAPT) in patients with ischemic heart disease. Information regarding Since the introduction of FVIII concentrates, the life expectancy of hemophiliac patients has improved and resulted in the rate of ischemic heart disease in this population is increased. Frequently the replacement therapy can trigger the onset of an acute coronary artery disease syndrome. We report a case of a patient with mild Hemophilia A, who presents with unstable angina, treated successfully with coronary angioplasty and drug eluting stent implantation without replacement of FV VIII, treated with long term DAPT without major bleeding after six months of follow up.