BackgroundDespite the increasing use of direct oral anticoagulants, low-molecular-weight heparin (LMWH) remains important in venous thromboembolism (VTE) care when oral therapy is unsuitable, temporarily unsafe, or difficult to manage, particularly during pregnancy, cancer-associated thrombosis, renal impairment, and peri-procedural care. Objective: To review how LMWH pharmacology informs practical decisions about dosing, anti-factor Xa monitoring, treatment interruption and restart, and switchi