This minireview discusses developmental approaches of novel anticoagulants. The technology of drug design has been successfully used to modify established anticoagulants in a way that the pharmacological activity and safety is improved. This is exemplified on the development of bivalirudin, a hirudin derivative, and of idraparinux, a synthetic heparin derived from fondaparinux. A second approach includes characterization of human or nonhuman anticoagulant proteins and their subsequent production using recombinant technologies. As an example the nematode anticoagulant protein NAPc2 that was originally isolated from the canine hookworm Ancylostoma caninum is discussed. Finally, the development of aptamers that inhibit activated factor IX is discussed. This example indicates that employment of a novel technology can extend the anticoagulant armamentarium.