Inherited factor VII (FVII) deficiency is the most frequently observed rare bleeding disorder. The clinical symptoms are extremely variable, and patients may be asymptomatic or may present with life-threatening bleeding disorders. FVII activity (FVII: C) values of 10-15% are considered safe for maintenance of hemostasis, and replacement therapy is recommended for some types of surgical procedures. Twenty-three adult patients with FVII:C deficiency are followed-up in the Ostrava Haemophilia Treatment Centre. Eleven patients underwent a total of fourteen invasive procedures between 2008 and 2013. In terms of replacement therapy, nine patients received plasma-derived FVII and five patients received activated recombinant FVII. None of the patients had excessive blood loss during surgery, and there were no bleeding or other complications during post-operative treatment. In addition, there were no thromboembolic events related to the use of replacement therapy.