OBJECTIVE: To evaluate the effectiveness of factor cover given to patients with congenital bleeding disorders while they went through circumcision on the duration and severity of bleeding and other complications. STUDY DESIGN: A Prospective cohort study. PLACE AND DURATION: Surgical unit II, Holy Family Hospital Rawalpindi and duration of study was 3.5 years. METHODOLOGY: During the period between January, 2011 to May, 2014. Male patients already diagnosed with congenital bleeding disorders who were admitted for circumcision upon request of their parents were included in the study. Factor replacement protocols devised by the Hemophilia Treatment Centre (HTC) of Pakistan Haemophilia Patients Welfare Society (PHPWS) ,Rawalpindi /Islamabad were followed . Age, type of bleeding disorder, family history, factor levels and inhibitor status (for children >1 year)were carried out at admission and recorded . Factor cover given pre- and post-operatively, method of circumcision and the duration and amount of bleeding, complications and hospital stay were also documented on a structured proforma and analyzed descriptively. RESULTS: A total of fifty four patients presented for circumcision. These included patients with Hemophilia A (forty four), Hemophilia B (eight) and one each of FVII and FX deficiency. Mean age was 2.2 years and family history was present in all but five patients. Inhibitors were not seen in any patient. Thirty nine patients did not bleed at all. Fifteen patients bled with a mean duration of bleeding being 1.7 hours. Bleeding was within ten percent of non-hemophilic patients. Three patients developed complications (infection and re-bleed). CONCLUSION: Circumcision can be carried out safely in patients with congenital bleeding disorders in a hospital where an experienced surgeon, a hematologist and factor replacement therapy are all available.