Improved understanding of the complex interrelated mechanisms that con
stitute haemostasis have provided new diagnostic and therapeutic optio
ns. Indeed, recent advances in DNA technology suggest that diagnosis a
t the molecular genetic level could soon be part of a 'routine' invest
igation of congenital haemostatic disorders. This update focuses on ar
eas of recent development within haemostasis, the key role of the endo
thelium and platelets, the molecular basis of inherited bleeding disor
ders and the therapeutic use of genetically engineered proteins and as
sessment of fibrinolysis. The use of standards and quality assessment
in haemostasis is also reviewed.