Background: Postpartum hemorrhage (PPH), which is a major cause of maternal death, is a life-threatening complication since vaginal delivery or cesarean section have been done. The essential treatment of major PPH consists of effective transfusion and uterotonic drugs as the first line management. We studied effect of activated recombinant factor VII (rFVIIa) on PPH patients as hemostatics. Methods: From December 2008 to December 2011, the medical records of PPH patient`s who visited the Emergency Department of OOOO Hospital, South Korea, have been reviewed retrospectively. We devided to two group, one is rFVIIa receiving group, another is not. We analyzed coagulopathy, prognosis, transfusion volume and Sequential Organ Failure Assessment score (SOFA score) when is arrived ED and after 24 hours of patients whose SOFA score is 8 points or over were analyzed. Results: The mean age of patients is 31.7±7.5 year old. There is no statistically significant difference between patients group that administered rFVIIa and not on initial and after 24 hours SOFA score. The interval change of SOFA score between initial and after 24 hours is significant in rFVIIa receiving group(p value=0.16). There are no significantly difference about transfusion volume of red blood cell (RBC), fresh frozen plasma (FFP), platelet (PLT) and period of admission at intensive care unit or hospitalization. Conclusion: The administration of rFVIIa may improve rapidly massive PPH patients. A quick dicision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients who have no effect about standard treatment.