Pseudotumour is a rare complication of severe haemophilia seen in only 1–2% of persons with the severe form of the disease (1, 2). These lesions were first described by Starker in 1918 as a slow progressive subperiosteal haemorrhage. These lesions may progress relentlessly if left untreated, resulting in compression and pressure necrosis of adjacent structures (1, 3–5). Due to the uncommon occurrence of this lesion, there are no standardized protocols for management. Treatment usually consists of the early and appropriate replacement of factor VIII, and surgical excision of the lesion to prevent further complications if it is progressively enlarging (6). The case of a young boy with severe haemophilia A who presented to the Orthopaedic Department with a pseudotumour of the left tibia is presented with a review of the clinical and radiological findings.