The recent launch of new oral anticoagulants provides more choices for clinicians to reduce the risk of stroke in patients with non-valvular atrial fibrillation. However, a great challenge is how to choice the most appropriate medication for patients, especially geriatric patients more vunlerable to comorbidity and organ failure that tend to increase the complexity of prescribing medication. The paper accordingly introduce the features of the new oral anticoagulants and the principle for their uses in the elderly.