Acquired factor VII (FVII) deficiency in the absence of vitamin K deficiency, oral, synthetic liver dysfunction, or DIC is rare, with only a handful of cases published in literature. Congenital deficiency of FVII is well known but, little is known about secondary FVII deficiency and its management. The knowledge of this syndrome should avoid false diagnosis of congenital factor VII deficiency. Here, we present the report of a young woman who presented with pyelonephritis, anaemia, prolonged prothrombin time and normal activated partial prothrombin time (aPTT). She was diagnosed to have acquired FVII deficiency and this was the first such case with pyelonephritis.