IntroductionFactor V (FV) deficiency, inherited or acquired, is a rare bleeding disease with an estimated prevalence of 1 per 1 million live births [1-2]. Patients with FⅤ deficiency may be bleeding by external or internal, from mild mucosal bleeding to severe, life-threatening hemorrhage. Patients with FⅤ deficiency usually need to improve their FⅤ levels to more than 25% to 30% by infusion of fresh frozen plasma (FFP) or cryoprecipitate (cryo) to ensure hemostasis and surgical safety during bleeding episodes or operative procedures. Platelets can be transfused when patients with FV deficiency have severe bleeding and do not respond well to conventional treatment [2]. The coagulation profile and factor assays are usually used to assess the coagulation status. Thromboelastogram (TEG) can provide information about the coagulation and fibrinolysis phases of the coagulation process, which includes the interactions of various blood components (platelets, plasma, and leukocytes) to guide transfusion therapy during surgeries [3]. In this report, we describe a patient with FV deficiency who underwent a surgical procedure. We used the above mentioned methods to assess and manage blood transfusion strategies.