Although mainly indicated for treatment of bleeding in haemophilia patients with inhibitors, recombinant activated factor VII (rFVIIa) has also been successfully used in other situations. However, no data are available on its use in the treatment of disseminated intravascular coagulation (DIC) secondary to septic shock. We report a man with DIC and septic shock due to retrocaecal appendicitis and severe intra-abdominal bleeding after surgery. Despite conventional treatment, the bleeding persisted, and treatment with rFVIIa controlled the haemorrhage. No side-effects related to rFVIIa were noted. This case suggests a potential role of rFVIIa in the treatment of severe bleeding associated with DIC.