Abstract: Oral anticoagulants can effectively reduce the risk of stroke in patients with atrial fibrillation. However, patients with atrial fibrillation and chronic renal insufficiency have an increased risk in both stroke and bleeding, making anticoagulant therapy challenging. Compared with traditional anticoagulant warfarin, non-vitamin K antagonist oral anticoagulants are non-inferior to warfarin in efficacy and safety. They don't require routine monitoring of the international normalized ratio and have better patient compliance. However, all the non-vitamin K antagonist oral anticoagulants are partially metabolized through kidneys to a varying degree, and thus their administration in patients with atrial fibrillation and chronic renal insufficiency is controversial. This review summarizes the administration of oral anticoagulants in these patients to guide clinical practice.