differ between younger and older patients with acute VTE. 7,8 Furthermore, evidence regarding the optimal treatment of VTE in the elderly, including first-choice anticoagulant agents and duration of anticoagulation, is limited, because elderly patients have been underrepresented in clinical trials. 7,9 As a consequence, the 2016 American College of Chest Physicians (ACCP) and the 2019 European Society of Cardiology (ESC) guidelines do not make specific recommendations for elderly patients and only acknowledge the higher risk of bleeding in this population. 10,11 Over the past decade, substantial advances in the treatment of VTE have been made. 12 Most notably, direct oral anticoagulants (DOACs) were introduced, which offer simple treatment regimens across a broad spectrum of patients with VTE. In light of the significant proportion of the elderly among patients with VTE and their distinct risk of VTE-related outcomes, in this review,