Atrial fibrillation (AF) is a strong, independent risk factor for stroke. Until recent years, only aspirin and warfarin were approved treatment options for prophylaxis of stroke in patients with AF. Although warfarin has shown significant superiority compared to placebo and aspirin in preventing stroke, challenges in its usage necessitated new treatment searches. New oral anticoagulants affect different factors in coagulation cascade and studies with this drugs was shown to be effective and safe. In this review, we evaluated the efficacy and safety of apixaban in patients that can not use warfarin therapy.