Dabigatran etexilate is an oral direct thrombin inhibitor approved it has been used in the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). It has been available in Taiwan since July 2011. Clinical trials on dabigatran etexilate have been promising and show the drug to have comparable efficacy and safety to warfarin. For these reasons, many clinicians are interested in dabigatran etexilate. The purpose of this article was to review the current evidence on dabigatran etexilate and discussed the clinical implications for clinicians and their patients.