Objective: to evaluate the latest evidence on the difference in gastroprotection generated by proton pump inhibitors (PPIs) and histamine receptor 2 antagonists (H2RAs) in anticoagulated patients, as well as the associated risk of gastrointestinal bleeding. Methods: narrative review. A literature search was conducted in the PubMed, ScienceDirect, Web of Science, and MEDLINE databases. Results: Among the described mechanisms explaining bleeding in the gastrointestinal tract are mucosal damage, alterations in local pH, platelet inhibition, coagulation factor alteration, and vascular lesions. Depending on the pharmacological group, anticoagulants can act on different targets in the coagulation pathway, altering the factors involved in this pathway and potentially triggering bleeding. Antisecretory drugs, on the other hand, aim to inhibit or reduce gastric acid secretion through interaction ...