Deep venous thrombosis (DVT) in high-risk fragile and cancer patient is associated with increased morbidity and mortality. Fragile patient and cancer associated thrombosis patients are estimated to be large number of more than 50% in DVT population treated for deep vein thrombosis. Increased incidence of major bleeding during the course of anticoagulant therapy very often create dilemmas between the safe treatment regime, appropriate pharmacotherapy and adequate drug dosage. The DVT guidelines are the state of knowledge in diagnosis and treatment and gave us the frame and rules for safe DVT treatment. (1-3) The author will give an overview of DVT treatment standard in high- risk patient and present recent literature data that could increase the awareness and possibilities of new treatment modality. Personalized approach for DVT is mandatory but the results of randomized trials that suggested fewer bleeding events in high-risk patients receiving new anticoagulant drugs might open new and safer era in DVT treatment.