The anticoagulants are the main drugs in the treatment and prevention of venous thromboembolism (VTE). Dabigatran is a direct competitive inhibitor of thrombin, in both free and bound to fibrin forms. The drug has a relatively stable anticoagulant effect and does not require monitoring. An orthopedic research has shown that dabigatran is no less effective than enoxaparin in preventing VTE. In the treatment of patients with atrial fibrillation it is more effective than warfarin, and no less effective in the treatment of patients suffering from VTE. Dabigatran is recommended in the primary prevention of VTE for patients after orthopedic operation. On the base of the results RELY study, FDA additionally registered dabigatran as a drug to be used for patients with atrial fibrillation in the prevention of stroke and other thromboembolic complications. Oral anticoagulant treatment with the fixed dose of dabigatran is a significant advance in the anticoagulant treatment.