 This paper reviews the development of anticoagulants and recent advances in clinical trials of experimental factor 11 inhibitors from a clinical application perspective. The results show that FXIA inhibitors are effective in reducing the risk of thrombosis without increasing the risk of bleeding. Furthermore, subgroup analyses suggest that FXIA inhibitors may be more effective than anoxaparin at preventing severe bleeding and clinically relevant hemorrhage. These findings suggest that FXIA inhibitors could potentially be used as an alternative to current anticoagulants with fewer side effects. This article was authored by Yin Qingxia, Yu Hu, and Liang Tang.