Antiphospholipid syndrome (APS) is a complex autoimmune clotting disorder and its treatment remains one of the most debated topics in hematology. In this episode, host Geoffrey Barnes sits down with Deepa Jayakody Arachchillage, founder of the APS Clinic at Hammersmith Hospital and Chair of the ISTH SSC Subcommittee on Antiphospholipid Syndrome. Together, they explore the evolving landscape of APS management, including whether direct oral anticoagulants (DOACs) have a role to play, the challenges of balancing clotting and bleeding risks, and how clinicians can apply the latest guidance to patient care.