This review summarizes the research progress of joint cartilage pathogenesis in hemophilia patients to further understand the unique mechanism of the development of cartilage damage to the occurrence of blood friends, and aims to provide new ideas to repair cartilage. English language databases, such as PubMed, Web of Science, SpringerLink, Google Scholar and Chinese language databases, such as CNKI, VIP and Wanfang, were selected. The English search key words were hemophilic, Joint bleeding, cartilage, Pathogenesis, cytokine, immunocyte, iron, synovitis, blood, plasma and signaling pathway. The Chinese search key words were hemophilia, joint hemorrhage, cartilage, pathogenesis, cytokines, immune cells, iron, synovitis, blood, plasmin and signal pathway. In accordance with the inclusion and exclusion criteria, literature with a high correlation of joint soft bone pathophysiology of hemophilia from January 1981 to March 2022 were searched, older or repetitive literature was excluded, and 60 related articles were finally included. and Conclusion Various cytokines, immune cells, iron ion deposition, chronic synovitis, blood, plasmin, and signaling pathways lead to chondrocyte apoptosis, leading to hemophilia cartilage injury in which iron ion deposition is critical for hemophiliac cartilage injury. Various influencing factors are interrelated and complex. How to regulate the damage of various influencing factors in articular cartilage is expected to become an important method to repair cartilage.