Abstract Background: Oral anticoagulants (OAs) are recommended for many clinical problems and their use requires organised and knowledgeable medical support. Up to our knowledge, there is no data about both the reasons of treatment among OAs’ users and the number of patients prescribed with OAs in Italy. Objectives: To describe the OA use, and the reasons of prescribing among Italian General Practitioners. Methods: We used the Health Search Database owned by the Italian College of General Practitioners to identify the clinical records of patients ≥20 years who had at least one prescription of OAs during the year 2002. Results: Among a study population of 448,495 patients, 3649 subjects (0.81%) had received at least one OAs prescription. Applying such a proportion to the overall Italian population, on the basis of data from Italian Office for National Statistics (ISTAT), we estimated that 376,882 patients would have used OAs during the year 2002 in Italy. The most frequent clinical problem related to the use of OAs was atrial fibrillation (45.6%), followed by cardiac valve disease (14.6%), deep vein thrombosis (12.2%) and peripheral artery embolism (7.7%). Conclusions: Approximately 370,000 patients are prescribed with OAs in Italy and for more than 50% of them life-long therapy is recommended. Atrial fibrillation is the most frequent reason for prescription.