Direct oral anticoagulant drugs (DOACs) or new oral anticoagulant drugs (NOACs) are medicines that achieve their anticoagulant effect by the direct inhibition of thrombin (dabigatran) or by the direct inhibition of activated factor X (rivaroxaban, apixaban and edoxaban). The use of DOACs means a step forward in the quality and safety of the treatment, and therefore in many indications the latest guidelines give them preference over the vitamin K antagonists, which have been anticoagulants of the first choice for a long time. Based on the results of large randomized studies which compared the effects of certain DOACs and warfarin, it can be concluded that in most cases DOACs are superior to warfarin in stroke and systemic embolism prevention. Thanks to their features, they are increasingly applied in clinical practice and in many cases they replace other anticoagulant drugs. One of the reasons for the increasing use of DOACs in treatment and prevention of venous thromboembolism as well as stroke and systemic embolism prevention in patients with atrial fibrillation is certainly a lower risk of serious bleeding compared to, for example, heparin and warfarin. However, bleeding that may occur during the usage of DOACs is a disconcerting side effect, as there is still a lack of adequate therapy or specific antidote for most of the DOACs. Patients treated with anticoagulant medicines make up a significant percentage of patients in emergency room services. Their treatment is very challenging, on the one hand because of the increased risk of bleeding and, on the other, because of the increased risk of thromboembolism due to the anticoagulant therapy interruption. This is a common case in various surgical procedures that are not unusual in emergency situations. Due to still insufficiently tested specific strategies for the reversal of the anticoagulant effects of DOACs, excluding dabigatran, invasive procedures often require a multidisciplinary approach and the use of protocols for specific situations. Although DOACs are associated with fewer interactions with other drugs compared to warfarin and heparin, the combination of DOACs and many drugs requires caution and, in some cases, clinical monitoring.