It is well known that there is a 5-fold increase in the incidence of strokes and systemic thromboembolic events in atrial fibrillation (AF) and anticoagulant therapy considerably reduces the risk of their development. Until recently, warfarin has been mainly used for this purpose. Dabigatran is the first representative of new-generation oral anticoagulants from a class of direct thrombin inhibitors to treat nonvalvular AF. Unlike warfarin, the drug provides a predictable and steady-state anticoagulant effect. This review presents the main pharmacological characteristics of dabigatran, the possibilities of its use in complex clinical situations in patients with AF in cardioversion, ablation, surgical/invasive interventions, hemorrhage, myocardial infarction, and stroke, as well as data on the use of the drug in real clinical practice.