Abstract : Dabigatran (Pradaxa®) is a new oral, direct, selective and reversible thrombin inhibitor (factor II a) acting as anticoagulant. Pradaxa® does not require monitoring or dose adjustment, except in cases of moderate renal insufficiency or in elderly patients (>75 years old). It is currently indicated for prophylaxis against venous thromboembolism after total hip or knee replacement surgery. Pradaxa® has been shown to be as effective as enoxaparin in reducing the risk of venous thromboembolism after total hip or knee replacement surgery, with a similar safety profile. The recommended dose of 220 mg is administered once-daily, starting with a half-dose 1–4 h after surgery. The total duration of treatment is 10 days for knee surgery and 28-35 days in case of hip replacement. Contrary to enoxaparin, with Pradaxa® there is no risk of drug-related thrombocytopenia. Of note, this promising new anticoagulant has also shown to be more effective than warfarin for stroke prevention in patients with non-valvular atrial fibrillation and as effective as warfarin for the treatment of acute venous thromboembolism (indications not recognized yet).