Venous thromboembolism (VTE) is a common cause of morbidity and mortality with an estimated annual incidence of 1 : 1,000. Patients show individual risk profiles with regard to recurrent VTE and treatment-associated bleeding, which are characterized by the presence of endogenous factors (such as hereditary thrombophilic disorders), but much more by exogenous factors (underlying disease). This results in risk-adapted therapeutic recommendations, which will be discussed in the following review.