A total of 20 AEs occurred, including two serious adverse events related to ALT elevation and a traumatic acetabulum fracture.<h4>Conclusion</h4>Valoctocogene roxaparvovec can offer durable FVIII expression in severe hemophilia A. This case provides valuable insights into personalised immunosuppression therapy with a favourable outcome for long-term efficacy and safety. Here, F8 is linked to hemophilia A.