Sports practice should be supported in people with severe hemophilia, but patient counseling and tailoring prophylactic treatment with clotting factors and non-replacement therapy is essential.

Introduction: This article discusses the current role of sports practice in people with hemophilia (PWH).

Areas Covered: On 11 January 2025, a bibliographic search was carried out in PubMed using 'hemophilia sports' as keywords. A total of 411 articles were found, of which only 22 were finally analyzed because they were directly related to the title of this article (inclusion criterion). The remaining 389 were eliminated because they were not directly related to the title of the article (exclusion criterion). It was found that sports activity is essential for patients with severe hemophilia to maintain joints' range of motion, diminish joint bleeding, enhance muscle mass and strength, improve proprioception, muscular throphism and bone mineral density, and avert secondary joint degeneration. PWH with factor levels < 10% during sports had a bleeding risk of 41% versus 20% in those with higher factor levels (>10%).

Expert Opinion: Prophylaxis therapy can permit patients with severe hemophilia to participate in vigorous activities or high-impact sports. Moreover, such activities or sports have a positive effect on patient's psychosocial health. Therefore, sports practice should be supported in people with severe hemophilia but patient counseling and tailoring prophylaxis therapy with clotting factors and non-replacement therapy is essential.