Appropriate anticoagulation therapy is an effective measure to prevent thromboembolic events in patients with atrial fibrillation, but at the same time it increases the risk of bleeding complications. Therefore, the benefit-risk ratio should be assessed before determining whether a patient is suitable for anticoagulation, and anticoagulation should be initiated only if the benefit of preventing thromboembolic events clearly outweighs the risk of hemorrhagic complications. The level of risk of ischemic stroke in patients with atrial fibrillation is closely related to their baseline characteristics, and risk stratification of patients based on baseline characteristics is the basis for the development of an appropriate anticoagulation strategy. Although there is conclusive research evidence that standardized anticoagulation for patients with atrial fibrillation at increased risk of thromboembolic events can significantly improve patient prognosis, most patients with atrial fibrillation in China are not treated with anticoagulants. In contrast, most of the patients on warfarin are not systematically monitored for international normalized ratio (INR) or the INR remains ineffectively low (1.3-1.5). The reasons for this situation are manifold, among which the lack of awareness of clinicians about the dangers of thromboembolic complications and the excessive concern about the increased risk of bleeding associated with conventional anticoagulant warfarin therapy are probably the main reasons. In fact, the benefits of anticoagulation in patients with atrial fibrillation far outweigh the risks of complications associated with anticoagulation therapy, provided that the indications are properly followed and coagulation is monitored as required by the relevant guidelines.