Abstract: Anticoagulation therapy is highly effective in preventing thromboembolism in patients with atrial fibrillation, deep vein thrombosis, or genetic predisposition, etc. Despite this advantage, however, anticoagu-lation results in an elevated risk of bleeding that may sometimes be life-threatening. There is excess concern in patients and physicians about the risk of bleeding from anticoagulation, which leads to the use of anticoagulation reportedly much less than expected. It is crucial to assess the bleeding risk and balance the benefit and the risk in order to plan a proper therapeutic regimen. An optimal decision on the therapy is based on a good balance between anticoagulation and bleeding according to the patient condition, the choice of an appropriate evaluation scale, a comprehensive assessment of coagulation, the right selection of medicine and dosage, and the enforcement of the management of anticoagulation therapy.