Summary: Due to the prevalence and profile of comorbidities in older adults, physicians often have to make challenging decisions about anticoagulation. Discussions with the patient and their caregivers regarding individual preferences and the balance between the benefits and risks of treatment should be preced-ed by performing patient-specific elements of a comprehensive geriatric assessment. When addressing problems of old age, we should individually assess the risks of treatment with anticoagulants (including the risk of bleeding), propose corrective methods and optimise management of these issues. The article presents a review of important geriatric problems that may affect the safety of anticoagulants in this group of patients. Due to their safety profile and ease of dosing, direct oral anticoagulants (DOAC) are currently preferred in older patients. Selected indications, differences, and dose modifications of anticoagulants specific to the older population are presented in this overview.