Bleeding disorders are generally considered absolute contraindications to laparoscopic surgery. We believe laparoscopic/retroperitoneoscopic renal surgery is an optimal choice in patients with hemophilia, because it minimizes tissue trauma. We present a case of successful retroperitoneoscopic renal surgery in a patient with factor VIII deficiency with a perinephric abscess that failed less invasive treatments. A fully equipped coagulation laboratory, experienced hematologists, and an experienced laparoscopic surgeon play a large role in the outcome in patients with bleeding disorders undergoing minimally invasive procedures. We conclude that although uncorrected bleeding disorders are absolute contraindications for surgical procedures, those that are corrected and appropriately monitored are not.