The Low molecular weight heparin (LMWH) and vitamin K antagonists (VKAs) were considered as the first line management option for the prevention and treatment of deep venous thromboembolism for several decades as warfarin was the only oral anticoagulation option; but new oral anticoagulants have the potential to change the management of coagulation disorders. As they differ from VKAs in their anticoagulation mechanism because of direct inhibition of proteins of the coagulation cascade. They have more predictable pharmacokinetics that leads to a fixed and convenient dosing regimens with no need for routine monitoring, as well as in a rapid onset of action, and high efficacy and low risk of bleeding. Their limitations are their higher cost, limited monitoring (if needed, as only qualitative measures available) and the lack of a specific antidote. This study aims to studythe short term outcome of two regimens Rivaroxaban versus warfarin in acute deep venous thrombosis treatment regarding their rate of recanalization using venous duplex. This work was done over 100 patients, divided into 2 equal groups: Group received Rivaroxaban for 1 month, and group 2 received warfarin. The following was done for all patients: creatinine venous duplex at time of diagnosis and another follow up after one month and rate of recanalization was assessed. Rivaroxaban (group 1) included 25 males and 25 females with a mean age of 54.14 (29-81), and a mean BMI of 24.64 ± 3.73. Warfarin (group 2) included 24 males and 26 females with a mean age of 52.04 (28- 80), and a mean BMI of 23.64 ± 3.57. There were 22% in the Rivaroxaban group had no or minimal recanalization versus 70% in the warfarin group. While 78% had partial to complete recanalization in the Rivaroxaban group versus 30% in the warfarin group with a statistical significant differences between the 2 arms of the study. Rivaroxaban showed a better rate of recanalization compared to warfarin in short term follow up of patients with acute DVT.