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Introduction: Prophylaxis is the recommended management strategy for all persons with hemophilia (PwH), yet its adoption is uneven worldwide., Areas Covered: This analysis examines global disparities in hemophilia care, focusing on global prophylactic coverage and its correlation with the World Bank's world development indicators. It outlines the disproportionate consumption of clotting factors and non-factor concentrates in high-income countries compared to lower-income counterparts and the challenges of expanding prophylaxis coverage in under-resourced settings. The analysis integrates socioeconomic data with global health indicators to understand these disparities and advocates for increased distribution of treatment resources across all income levels, emphasizing the need for policy changes to improve hemophilia care worldwide. Studies addressing the prophylaxis perspectives in hemophilia were selected using PubMed and Google Scholar platforms (unlimited time frame). Articles were supplemented with WFH's annual surveys and guidelines, including the WFH Global Survey 2022, WFH Guidelines for the Management of Hemophilia 2020 and World Bank data., Expert Opinion: Significant disparities in hemophilia care and factor usage exist between high-income and lower-income countries. Standardized, harmonized metrics for different types of factor consumption are critical to accurately assess and compare hemophilia care on an international basis.