In this special episode of the ISTH Pulse Podcast, recorded live at #ISTH2025, host Dr. Geoffrey Barnes sits down with two global leaders in anticoagulation care—Dr. Lana Castellucci and Dr. Allison Burnett—to explore the vital role of antithrombotic stewardship in improving patient safety and treatment outcomes. As the use of anticoagulants continues to grow, so too does the need for thoughtful, coordinated approaches to prescribing, monitoring, and managing these high-risk therapies. Together, our guests share real-world insights from research and practice, offer practical strategies for building successful stewardship programs, and discuss how multidisciplinary collaboration can drive safer, more effective care.