Hospitalised cancer patients are at a significantly high probability of developing acute venous thromboembolism (VTE) due to immobilisation, making it a leading source of morbidity and death. This has a significant influence on the quality of life of cancer sufferers. The basic treatment of VTE is anticoagulation but unfortunately, cancer patients had higher risk of bleeding when anticoagulated compared to non-cancerous patients. Thus, there are two primary challenges related with anticoagulation therapy in such individuals, first higher risk of recurring VTE and second haemorrhagic issues. Earlier long-term therapy with low-molecular-weight heparins (LMWHs) and Semuloparin was the mainstream of therapy for the management of thrombosis but now direct oral anticoagulants (DOACs) are preferred. Due to the quick beginning of action, they have emerged as a novel alternative therapy for patients with acute disease or diminished movement in the absence of bleeding or any other contraindications. Patients admitted for minor surgeries or chemotherapy infusions, as well as those going through stem cell/bone marrow transplantation, should not be given routine pharmacologic thromboprophylaxis. If there are no substantial risk factors for bleeding and no medication interactions, high-risk outpatients with cancer may be administered thromboprophylaxis with apixaban, rivaroxaban or LMWH prior to commencing a new systemic chemotherapy treatment. Properly assessing the level of risk and implementing necessary measures to avoid VTE are crucial in the management of cancer patients. The clinicians should always address the advantages and risks, medicine cost and length of prophylaxis with the patient before starting the treatment strategy.