Abstract: Objective To investigate the effect of anticoagulant therapy in elderly patients with non-valvular atrial fibrillation. Methods A total of 60 non-valvular atrial fibrillation patients treated with warfarin and rivaroxaban were selected, and were divided into elderly group［n=32, with an average age of(73.22±5.75)years］and senile group［n=28, with an average age of(85.86±3.31)years］. The incidence of cerebrovascular accident events, peripheral vascular thromboembolism, indigestion, skin mucosal bleeding of the two groups were compared. Results The incidence of cerebrovascular accident events in the senile group was significantly higher than that in the elderly group(10.71% vs. 6.25%, P>0.05). There were 3 patients with cerebral hemorrhage treated by warfarin and no cerebral hemorrhage was found in patients treated by rivaroxaban, a significant difference was found(P<0.05). The incidence of peripheral vascular thromboembolism events in two groups showed no significant difference(P>0.05). The incidence of adverse events in the senile group was lower than that in the elderly group, but showed no significant difference in(21.43% vs. 21.88%, P>0.05). Conclusion The elderly patients with atrial fibrillation treated by rivaroxaban have lower incidence of cerebrovascular accident events and it is safer.