Recombinant activated factor VII is a drug that should be considered when there is massive bleeding. Its activation after it is bond to the tissue factor expressed triggers the coagulation cascade by action sequence of the different factors. Since its approval as treatment for bleeding episodes in patients with hemophilia, its indications have been increasing. It is a drug is indicated in non-traumatic intracranial bleeding, in patients with severe multiple traumas, and in those bleeding conditions that may affect patient viability. Although the adverse effects are well characterized, it is still a newly used drug. Thus, the potential risks of its use in each patient must be weighed.