Acquired hemophilia A (AHA) is a severe condition characterized by significant bleeding and is sometimes associated with plasma cell disorders. Emicizumab, a bispecific antibody, mimics the coagulant function of factor VIII (FVIII) without being neutralized by FVIII antibodies, making it a promising treatment for preventing bleeding in AHA patients. It offers convenience and stable hemostatic effectiveness compared to intravenous agents that bypass FVIII, which can allow flexibility in the timing and intensity of immunosuppressive therapy (IST). Moreover, as demonstrated in this case report, targeted anti-myeloma treatment in plasma cell dyscrasia's related AHA may be more effective than conventional IST in achieving AHA control. By addressing the underlying plasma cell disorder directly, anti-myeloma therapy may contribute to a more durable response in AHA, while also mitigating the adverse effects linked to IST. This approach is particularly beneficial for older patients with multiple comorbidities, who are at elevated risk for thrombotic, bleeding, and infectious complications. Emicizumab, in conjunction with targeted myeloma treatment, thus represents a promising strategy to improve outcomes for AHA patients with multiple myeloma.