Joint damage (hemophilia arthopathy) is the most common complication of bleeding in hemophilia. Prophylaxis has been shown to reduce joint bleeding and prevent joint damage. Early treatment of each joint bleed reduces the risk of chronic joint disease, functional impairment, and disability. Factor concentrates, home treatment, physical therapy, and orthopedic surgery have contributed to decreased frequency and severity of joint disease among people with hemophilia during the past 25 years. Prevention remains the focus of hemophilia treatment centers (HTCs).