The American College of Chest Physicians (ACCP) guidelines recommend thromboprophylaxis with low molecular weight heparin (LMWH) for the prevention of venous thromboembolism (VTE) in pregnant women with a history of VTE and a moderate-to-high risk of recurrence. Thromboprophylaxis is not recommended in certain cases. Vitamin K antagonist (VKA) use is not recommended during pregnancy, but the use of warfarin and acenocoumarol are options after childbirth. The use of fondaparinux and parenteral direct thrombin inhibitors should be limited to women with severe allergic reactions to heparin. Novel oral agents, such as dabigatran, rivaroxaban, apixaban and edoxaban, are not recommended in current guidelines owing to lack of clinical data in pregnant women.