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Abstract Background & aim: Pain and limited range of motion (ROM) are the crucial subsequent results of joint hemorrhages in patients suffering from hemophilia. Different training protocols designed to treat these patients are of great importance. The purpose of this study was to compare the effects of drought and water therapy on pain and range of motion of the knee in hemophilia patients. Methods: In this present clinical-trial study, 40 patients with hemophilia type A were randomly divided into three groups: exercise therapy on land, hydrotherapy, and control groups. The first two groups attended their special exercises on three days within 4 weeks, but the control group were only subjected to their daily life activities. Experimental pain, flexion and knee extension were measured using a visual analogue scale (VAS) and standard Goniometer at the beginning and after the intervention. Data were analyzed by ANOVA and Scheffe’s test (P<0.05). . Results: Both experimental groups exhibited significant reduction of pain along with improved knee flexion and extension compared with the control group (P<0.001). Pain reduction in subjects treated in water treatment was significantly higher than exercise group in drought (P<0.001), but no significant changes was seen in flexion and knee extension of the two exercise groups (P>0.05). Conclusion: The use of therapeutic exercise in water with regular exercise rehabilitation for patients with hemophilia can be helpful to reduce pain and improve range of motion in hemophilia patients. The effect of exercise therapy on pain reduction is more effective compared to traditional pain therapy. Key words: Hydrotherapy, Exercise Therapy, Hemophilia, Knee Range of Motion