More than 90% of bleeding episodes in patients with haemophilia occur in the musculoskeletal system, of which most episodes occur in the joints. Haematoma formation in muscles, with the development of pseudotumours, may compromise neurovascular structures. The incidence of chronic compressive peripheral neuropathies due to extrinsic causes is low. Acute nerve compression due to intraneural bleeding in patients with haemophilia is a rare entity. We report on acute ulnar nerve compression due to intraneural bleeding, accompanied by median nerve symptoms and present a practical guide to the orthopaedic management of these patients.