A two-step, fully automatic virtual screening procedure consisting of flexible docking followed by activity prediction by COMparative BINding Energy (COMBINE) analysis is presented. This novel approach has been successfully applied, as an example with medicinal chemistry interest, to a recently reported series of 133 factor Xa (fXa)(1) inhibitors whose activities encompass 4 orders of magnitude. The docking algorithm is linked to the COMBINE analysis program and used to derive independent regression models of the 133 inhibitors docked within three different fXa structures (PDB entries 1fjs, 1f0r, and 1xka), so as to explore the effect of receptor conformation on the overall results. Reliable docking conformations and predictive regression models requiring eight latent variables could be derived for two of the fXa structures, with the best model achieving a Q(2) of 0.63 and a standard deviation of errors of prediction (SDEP) of 0.51 (leave-one-out). The two-step procedure was then employed to screen a designed virtual library of 112 ligands, containing both active and inactive compounds. While docking energies alone could show a good performance for selecting hits, including structurally diverse ones, inclusion of COMBINE analysis regression models provided improved rankings for the identification of structurally related molecules in external sets. In our best case, a recognition rate of approximately 80% of known binders at approximately 15% false positives rate was achieved, corresponding to an enrichment factor of approximately 450% over random.