Antiphospholipid syndrome (APS) is an acquired autoimmune disorder characterized by venous or arterial thrombosis, and recurrent pregnancy morbidity in the presence of antiphospholipid antibodies. Many physicians recommend a daily low dose of aspirin for primary thrombosis prevention in asymptomatic individuals with persistent antiphospholipid antibodies. However, recent data question the effectiveness of aspirin. For the secondary prevention of recurrent thrombosis, the most effective treatment is long-term anticoagulation. A moderate intensity of anticoagulation is recommended in the majority of APS patients. In cases of catastrophic APS, an aggressive therapy is highly recommended using immunosuppression and anticoagulants. This article will also review the experimental evidence of potential therapeutic approaches for the management of APS-related clinical events.