This article reviews the pharmacology and clinical evidence of the use of dabigatran etexilate (DE) in the prevention and treatment of venous thromboembolism (VTE). Published data in English language were identified from MEDLINE and Current Content database (1966 to January 30, 2011) using the search terms dabigatran, VTE, deep vein thrombosis, and pulmonary embolism. Citations from available articles were reviewed for additional references. DE is an oral direct thrombin inhibitor that has a rapid onset of action, achieving peak anticoagulation effect in 0.5–2 hours. In clinical studies, DE has demonstrated superiority and non-inferiority to enoxaparin for VTE prophylaxis and non-inferiority to warfarin for VTE treatment. A common side effect of DE is gastrointestinal complaints. The overall rates of major bleeding were low, and minor bleeding was commonly noted but similar in incidence to other anticoagulant (enoxaparin and warfarin). Future studies should focus on long-term efficacy and safety compared to other anticoagulants, and for other clinical indications.