Improving bone health and preventing osteoporosis is an essential approach for hemophilia patients. Regarding precautions, the treatment model may affect bone health. To detect the effect of a treatment model (prophylaxis/on-demand treatment) on bone metabolism in patients with severe hemophilia A was the primary aim of this study. The biochemical markers of bone metabolism and bone mineral density were obtained from the patients enrolled in the study. No statistically significant differences were found between the groups due to the limitations of the prophylaxis group, such as adaptation problems, personal differences, and type of prophylaxis.