Currently, patients treated with direct-acting oral anticoagulants (DAOAs) are an increasingly frequent population group in our health centres. The management recommendations of these patients, which are going to be subjected to invasive-diagnostic or surgical tests on a scheduled basis, are included in clinical practice guidelines and reviews. However, to date, all guides have the degree of evidence of expert recommendation. Recently with the publication of the PAUSE study the existing recommendations are likely to change. This review refers to different aspects in relation to the perioperative management of patients treated with DAOAs and the existing controversies.