 The study presents a 40-year retrospective review of surgical management of hemophilic pseudotumus in China with a focus on the clinical signs, surgical outcomes and complications. The results show that complete surgical resection can be achieved for proximal pseudotumus in extremities but may not be possible for pelvic or abdominal pseudotumus due to potential injury to vital organs. Delayed healing of the incision, allergic reactions and ureteral injury are common complications that require careful management by a multidisciplinary team.