Destructive and reparative changes in haemophiliac arthropathy can be observed particularly well in the elbow, since bleeding occurs usually in childhood during development of the epiphyses. These appear prematurely as a result of florid hemophiliac changes. They are enlarged and their structure is altered. Stress areas show typical impression deformations and in other areas the bone becomes expanded. Extensive deformities are irreversible and usually lead to severe functional impairment. It is, however, of therapeutic importance to evaluate these changes radiologically. The literature contains various special features of hemophiliac arthropathy of the elbow. As early as 1897, two years after the discovery of x-rays, Shaw described enlargement of the head of the radius. Increased depth of the groove of the trochlea, of the incisura radialis ulnae and of the olecranon fossa are regarded as typical. Deformities of the tip of the olecranon and of the coronoid process are also described (De Palma 1956, Jordan 1958, Ahlberg 1965, Weseloh 1973). At the rehabilitation centre for children and adolescents at Neckargemünd, 100 hemophiliacs have been examined systematically. Development of the arthropathy has been followed for a period of five years. Three typical hemophiliac arthropathies of the elbow are described and discussed. Classification is proposed according to a system published in 1980.