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Background: In patients of cancer associated venous thromboembolism, low molecular weight heparin (LMWH) combined with a vitamin K antagonist is currently recommended as the first treatment of anticoagulation. Rivaroxaban, an oral direct factor Xa inhibitor, is attractive option in the cancer population, with their oral formulation, no need of monitoring. The purpose of this study is to evaluate efficacy and safety of rivaroxaban in patients with cancer associated venous thromboembolism. Methods: We performed a retrospective chart review in cancer patients for pulmonary embolism or deep vein thrombosis. Our analysis included all patients who received for rivaroxaban between March 1, 2013 to June 30, 2016 at Hemato-oncology division, Pusan National University Hospital in Korea. Results: Preliminary results identified 123 patients with a history of cancer that were treated with rivaroxaban. In solid tumor malignancy, the most common type of cancers identified were colo-rectal 13% (n ¼ 16), lung 13% (n ¼ 16), and stomach 8.1% (n ¼ 10). The average age of patients was 63.34, 42.3% of patients were male. During a mean follow up of 25.3 months, 56.9% (n ¼ 53) of patients diagnosed pulmonary thromboembolism, 58.5% (n ¼ 72) of patients diagnosed deep vein thrombosis, and 13.8% (n ¼ 17) of patients had both of them. Of the 123 included patients, 42.3% (n ¼ 52) of patients were classified as incidental venous thromboembolism and 57.7% (n ¼ 71) as symptomatic venous thromboembolism.The average duration of rivaroxaban therapy was 95.25 days. 35 patients resolved venous thromboembolism after initiation of rivaroxaban, only 1 patient recurred on rivaroxaban treatment. Major bleeding was observed in 4.8% (n ¼ 6) patients, and minor bleeding was observed in 8.9% (n ¼ 11) patients. The majority of bleeding events occurred spontaneously, and most of bleeding could be treated conservatively. Among 52 deaths patients (42.3%), none of patients died due to venous thromboembolism or bleeding complications, the majority of cause of death is cancer progression.