The range of anticoagulants has been very active recently with the development of new compounds including injectable anti-Xa such as fondaparinux, and new oral drugs which can be divided into anti-IIa with dabigatran, and anti-Xa, such as rivaroxaban and apixaban still in the development stage. Others are coming forward. They are more convenient to use and do not require routine coagulation monitoring. However, several points need to be clarified and the place for each drug remains to be determined. In case of massive bleeding, management is unclear and none of these newer agents has a specific antidote that completely reverses its anticoagulant effect.