Patients with venous thromboembolism (VTE) and concurrent coronary heart disease (CHD) are not rare in clinic. The main challenge in the treatment for these patients is that the antithrombotic therapies for VTE and CHD are different from each other, but the combination of the two therapeutic strategies would increase the risk of bleeding. There is a need to optimize the antithrombotic therapeutic scheme on the basis of individual conditional, in order to balance the therapeutic effects and the bleeding risk. This article discussed the appropriate antithrombotic therapy when balancing the effectiveness and the risk in different circumstance of concurrence of VTE and CHD, such as combining anticoagulation therapy, dual antiplatelet therapy (DAPT), triple antithrombotic therapy (TAT), thrombolytic therapy and extending therapy, in order to provide safe, standard and effective therapeutic schemes for the clinical management of these patients. In the meantime, this article also provides perspectives regarding the application of novel non-vitamin K anticoagulants (NOACs) and the assessment tools of bleeding risk.