Floating thrombi can occur in any part of thoracic aorta and cause distal embolism. The main causes of thrombosis may be atherosclerotic plaque, intimal dissection, hypercoagulation or hematological disorders caused by medications. There is a surgical method of these patients with obvious effectiveness. However, there is also a conservative approach ensuring favorable results including those with previous COVID-19. The authors present conservative treatment of a patient with floating aortic thrombus after previous COVID-19. Diagnostic algorithm included ultrasound, echocardiography, and contrast-enhanced computed tomography of the aorta. Therapy included rivaroxaban 15 mg 2 times a day for 30 days and then warfarin 2.5 mg (³/₄ tablets) for 46 days. Target INR was 3.5—4.5. After therapy, control CT angiography of aorta revealed more than 2-fold reduction of thrombus.