Anticoagulants are the class of drug that is frequently used for treating and preventing thromboembolism. Generally Vitamin K antagonists (Warfarin) have been the usual treatment and the merely orally available agent for more than 60 years. Dabigatran was the first new oral anticoagulant and their metabolites (acyl glucuronides) are competitive, direct thrombin inhibitors. We know that in the coagulation cascade thrombin converts fibrinogen to fibrin. Dabigatran acts by inhibiting thrombin which thereby prevents the development of thrombus. Active moieties inhibit thrombin induced platelet aggregation as well as free and clot-bound thrombin. We report a case of 65 years old female patient who have experienced nasal bleed, per-rectal bleed and ecchymatic patches all over the body after 10 days of administration with Dabigatran. Patient had a previous history of admission to hospital for treatment of Deep vein thrombosis. Ecchymosis is a uncommon but potentially fatal complication caused by Dabigatran, which necessitates careful monitoring of patients receiving this medication. Because of the efficacy and good safety profile of Dabigatran, clinicians should be informed about this rare adverse effect.

Index Terms- Dabigatran, Ecchymatous patches, Prothrombin time, INR.