Diffuse alveolar haemorrhage is a severe clinical disorder that may be life-threatening. The early diagnosis of diffuse alveolar haemorrhage and prompt intervention is crucial. Recombinant factor VIIa has been used extensively for the treatment of haemophilia A and B patients. More recently, recombinant factor VIIa has been used successfully for the treatment of bleeding in patients without pre-existing coagulopathy. We describe the successful use of recombinant factor VIIa in a patient with diffuse alveolar haemorrhage secondary to pulmonary-renal syndrome.