Introduction: A balance between the coagulation systems is achieved by complicated pathways that involve platelets, the vascular endothelium, the coagulation cascade, and the fibrinolytic system. In case of conditions that predispose to higher coagulability, anticoagulants are used to prevent adverse outcomes. However, strict monitoring is required to maintain the balance of thrombogeneis and prevent dangerous complications such as bleeding. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE from January 1987 to March 2017. The following search terms were used: anticoagulant, heparin, warfarin, unfractionated heparin, factor Xa inhibitor Aim of the work: In this study we aimed at understanding the different types of anticoagulants used and also focus on the adverse effects and their reversal. Conclusion: Acute bleeding remains the most important concern when using anticoagulants and its risk is present with all agents. Although this bleeding is rarely fatal, its recognition and proper treatment is crucial and significantly affects outcomes.