This narrative review delves into the pivotal role of clinical pharmacists in optimizing anticoagulant therapy, focusing on evidence-based practices, patient safety considerations, integration of technology, quality improvement initiatives, implications for practice, and recommendations for future research. Evidence-based practices explored include anticoagulant stewardship programs, collaborative care models, utilization of clinical decision support systems, and pharmacist-led anticoagulation clinics. Patient safety aspects cover risk assessment and management, bleeding complications, thrombotic events, and patient monitoring strategies. The integration of technology, such as electronic health records, telehealth, mobile applications, and artificial intelligence, is discussed in optimizing anticoagulant management. Recommendations for future research emphasize long-term outcomes of pharmacist interventions, comparative studies on clinical models, health economic analyses, and patient-centered research approaches. Overall, this review underscores the importance of pharmacist collaboration in anticoagulant therapy, outlines future directions in clinical pharmacy practice, and advocates for patient-centered care in anticoagulation management.