Today anti-coagulation is the mainstay therapy of many diseases, chiefly stroke prevention in patients who are suffering from non-valvular atrial fibrillation and prophylaxis of venous thromboembolism. Vitamin K antagonists (VKA) such as warfarin are being used for decades. VKA proved to be very cost-effective solution that when combined with vast body of experience made them one of the more prescribed drugs in the global market. In the begging of the last decade a new group of drugs was introduced, the direct oral anticoagulant or DOAC for short. DOACs improved on the efficacy and safety with a predictable effect that doesn’t requires weekly monitoring. However, physicians are still hesitant in using these new agents, lack of familiarity and the absence of a reliable reversal strategy are perhaps the leading contributors. It was only recently that a specific reversal agent was introduced (Idarucizumab for dabigatran). Availability of reversal agent have the potential to change the guidelines recommendations for the use of DOAC over VKA. With more reversal agents in development, DOAC popularity among physicians and patient is bound to grow, our familiarity with these agents need to grow accordingly.