Important facts about recombinant human factor VIIa have been mentioned, also about the renal cell carcinoma. Case report: Male, aged 69, with infiltrative renal cell carcinoma, underwent radical nephrectomy using Hasagawa`s approach. Extirpated tumor had 35 cm in diameter. During the surgery, patient suffered a cardiac arrest with 3500 ml blood loss. After operation, he lost 2100 ml more blood. Despite of active blood supstitutions with intensive surgical attempts in order of haemostasis, bleeding did not stop untill the application of rFVIIa (300 I. U.). Patient survives and recovers completelly. Conclusion: RFVIIa is very succesful in controling of massive surgical bleeding, possibly associated with paraneoplastic syndrome.