The majority of the patients presenting with venous thromboembolism are in need of anticoagulation therapy. The decision to start the treatment with anticoagulants, continue or terminate it within different periods after the first thrombotic event should be made taking into consideration the results of assessment of the risk-benefit ratio on an individual basis. Such assessment should be based on reliable clinical endpoints and may pose a serious challenge for the clinicians. Objective of the study. To develop the tactical algorithm of anticoagulation therapy based on a review of relevant trials and studies. Material and methods. The search for and the analysis of the publications reporting the  clinical studies evaluating the effectiveness and safety of various means of anticoagulation, as well as research assessing the benefits and risks of extension or withdrawal of anticoagulation treatment of venous thromboembolism were carried out making use of the Medline database regardless of the publication time. The following selection criteria were employed: randomized controlled trials, prospective cohort studies, systematic reviews or reviews with the meta-analysis of the data on specific issues pertaining to the management of venous thromboembolism. In addition, we have taken into account Russia’s clinical recommendations on diagnostics, treatment and prevention of venous thromboembolism (2010), Handbook of Venous Disorders Guidelines of the American Venous Forum (2009), recommendations of the International Society on Thrombosis and Haemostasis (2012), UpToDate, version 20.3 (2014). Conclusions. The necessity and duration of anticoagulation therapy depends on the nature of the thromboembolic event (idiopathic or induced venous thromboembolism), the level of vascular destruction, and the risk of bleeding during anticoagulation therapy. The patient’s preferences should be taken into consideration when making the decision about the beginning of anticoagulation therapy. This review and the proposed algorithm can be used as reference materials for  the  benefit/risk assessment of the onset or extension of the anticoagulation treatment on the individual basis.