Hepatic rupture after blunt abdominal trauma may lead to severe bleeding, depletion and consumption of clotting factors, with the risk of packing to defer the definitive operation. We report two cases of hepatic rupture after blunt trauma with intrahepatic hematoma and severe intraabdominal bleeding. In both cases the bleeding could be stopped by early intervention with recombinant activated factor VIIa (rFVIIa). In neither case was surgical intervention necessary and after 3 weeks both patients were released without complications. These cases demonstrate that the early therapy with a single dose of rFVIIa before the development of a hemostatic crisis is a therapeutic option in selected cases where surgical therapy of the bleeding is difficult and risky.