Twenty-one affected elbows in 14 known hemophilic patients undergoing treatment at the Hemophilia Clinic of our institution between 1994 and 1997 were evaluated using the clinical evaluation score of the Orthopaedic Advisory Committee of the World Federation of Hemophilia and radiological examination using the Pettersson score. The mean age of patients was 16.2 years (range 10-25 years), and all patients except 1 had severe hemophilia with factor VIII levels less than 1% of normal. The mean duration of disease at the time of presentation was 12.8 years. The mean clinical score was 6, while the mean radiological score was 4.9. There was a positive correlation between the clinical and radiological scores (P < 0.0001). However, the clinical and radiological scores did not correlate with either duration of disease or joint bleeding score. Two new radiological signs of obliteration of the capitello-lateral epicondyle groove with rounding off of the lateral aspect of the distal humerus and lipping of the medial trochlear surface were also recognized in hemophilic arthropathy of the elbow.