Factor X has an essential role in the fibrin formation pathway, as it is the first enzyme in this cascade. Factor X is one of the rarest bleeding disorder that can be inherited or acquired. This case report describes two members of a family who were found to have factor X deficiency. A 2 years 9 months old boy who presented to the ED with intra-muscular hematoma. Work up revealed factor X deficiency. The low incidence and rarity of this deficiency producing significant complication compelled us to report this case.