We report the case of a severe postpartum hemorrhage (PPH) that was successfully treated with two administrations of recombinant activated factor VII (rFVIIa). Two major thromboembolic events (TEE) occurred shortly afterwards: the first was an acute lower limb ischemia at H3, the second was a cardiac arrest complicating a massive pulmonary embolism on day 5. Fortunately, both events had a favorable outcome. This case report allows us to discuss the role of rFVIIa during severe PPH and its potential responsibility in these two major TEE. (C) 2010 Elsevier Masson SAS. All rights reserved.