Background: Several variables, one of which is geography, influence the prevalence of bleeding disorders. Even minor bleeding issues may cause iron shortage, illness, and even death in extreme circumstances. Clinicians have a difficult but essential challenge when attempting to quantify hemorrhagic symptoms as part of the therapy of bleeding diseases.

Methods: A comprehensive search was conducted using electronic databases, including PubMed, Embase, and Cochrane Library, to identify relevant studies published from 2000 to 2023. The search was limited to English-language studies that examined the prevalence and etiology of ecchymosis in KSA.

Results: This systematic review investigated 26 studies initially identified from major databases, ultimately selecting 10 for in-depth analysis. Two pivotal studies were featured, providing insights into bleeding disorders from diverse perspectives. The first study examined bleeding disorders in adult students across four locations in Saudi Arabia, revealing significant regional variations (14.03% to 32.3%) and gender differences (54.9% females, 45.1% males). It emphasized the necessity of quantifying hemorrhagic symptoms and advocated for a nationwide monitoring system. The second study focused on von Willebrand Disease patients in a Saudi tertiary care hospital, uncovering diverse bleeding sources and highlighting blood type O's significant associations. The results underscored the complexity of bleeding disorders and advocated for tailored diagnostic and treatment strategies, contributing valuable information for future research and clinical practice.

Conclusion: The results of this research show that moderate bleeding problems are more common in certain ethnic groups and that men and women experience them differently. To better treat these patients, a nationwide monitoring system is necessary. Our cohort's most prevalent clinical manifestations were bleeding in the muscles and joints. Our group had the highest incidence of type 1 vWD, but type 3 was much more common, which may be attributable to racial disparities or referral bias. In terms of FVIII and vWF:Ag, we discovered a statistically significant difference between O and non-O blood types. In terms of vWD activity, as measured by vWF:RCo, we found an even more dramatic difference, with blood type O serving as the underlying component.