Pulmonary hemorrhage (PH) is rarely seen in neonates and generally occurs based on the pathological process as perinatal asphyxia. Additionally, hypothermia treatment can be associated with thrombocytopenia and hemorrhage in term infants. Generally, PH is severe and persistant hemorrhage can related to neonatal mortality. Sometimes, supportive therapies such as positive-end expiratory pressure (PEEP), antibiotherapy, and fresh frozen plasma may not affect PE in neonates. Tranexamic acid (TXA) is an antifibrinolytic agent that can reduce bleeding and decrease blood transfusions in pediatric surgery. In this study, a 5-year-old girl was reorted that who was presented with a 4 month history of pelvic and right lower limb pain and limping to the pediatric outpatient clinic in August 2016  at Shahid sadoughi Hospital,Yazd,Iran. In this case report, a severe PH was presented and treated with TXA. PH was reduced after administering first dose of TXA and full recovery was achieved on 3th day of therapy. No bacterial agent was observed in hemoculture result during first 72 hours and hemocoagulation was not affected with TXA administration.