Recent years have witnessed an increased worldwide interest in medical use of unique naturally occurring enzymes - subtilisins possessing pronounced fibrinolytic and anti-inflammatory properties. The article deals with experience in clinical administration in vascular surgery of new therapeutic agent Thrombovasim® containing pegylated subtilisin as an active substance. Thrombovasim® has a favourable profile of safety, good tolerance and causes no severe haemorrhagic complications. The pharmacological action of Thrombovasim® consists in combination of the targeted effect on the fibrin carcass of the thrombus without participation of the own system of haemostasis and anti-inflammatory effect. In the Russian Federation Thrombovasim® has been used for 6 years predominantly in vascular pathology of lower limbs accompanied by the development of chronic venous insufficiency.