Anticoagulants are used in the treatment and prevention of thromboembolism. The most common indications for long-term anticoagulation with warfarin are atrial fibrillation, mechanical heart valves and venous thromboembolism. A number of anticoagulants are available, including unfractioned heparin, low molecular weight heparin, and the vitamin K antagonists; warfarin, acenocoumarol and phenindione. These anticoagulants have been used for many years, and at present most people who require an anticoagulant are prescribed warfarin.However, recent national guidelines have recommended the use of New oral anticoagulants(NOAC) in certain circumstances. The new oral anticoagulants; rivaroxaban, dabigatran and apixaban have all completed phase III clinical trials for stroke prevention in patients with atrial fibrillation, and many countries, including the United Kingdom, have approved the use of the new oral anticoagulants for the prevention of cerebrovascular accidents and systemic embolism in patients with atrial fibrillation and the treatment and prevention of deep vein thrombosis and pulmonary embolism.This report aims to look at the peri-operative management of patient using the NOACs.