Data regarding efficacy and safety of direct oral anticoagulant rivaroxaban in prevention of stroke in elderly polymorbid patients with non-valvular atrial fibrillation are presented. In this aspect results of randomized clinical trial in direct comparison of rivaroxaban and warfarin in patients with non-valvular atrial fibrillation ROCKET-AF are discussed. Results of rivaroxaban use in elderly patients in real medical practice are also considered.