Transfusion therapy for the congenital coagulopathies has changed considerably in recent years. Improved donor screening, purification, and virucidal methodologies have resulted in much safer plasma-derived clotting factor concentrates. Additionally, synthetic products such as rF VIII and DDAVP are licensed and available. For persons with hemophilia B, nonthrombogenic coagulation F IX concentrates are available. Treatment recommendations for each of the congenital coagulopathies are discussed.