The risks of thromboembolic and hemorrhagic events in patients with atrial fibrillation both increase with age; therefore, net clinical benefit analyses of anticoagulant treatments in the elderly population are crucial to guide treatment. We evaluated the 1-year clinical outcomes with non-vitamin K antagonist and vitamin K antagonist oral anticoagulants (NOACs versus VKAs) in elderly (≥75 years) patients with atrial fibrillation in a prospective registry setting.