Anticoagulant medicines provide care strategies for potentially fatal thromboembolic disorders. They also pose major safety hazards, so it's important to think carefully about the amount of the medicine, keep an eye on the person, and follow up. Inpatients are especially at danger since hospitals use a lot of anticoagulants. This has led to the creation of safety objectives for anticoagulants in Canada and the US. These goals call for more engagement from pharmacists to protect patients. The purpose of this evaluation is to assess the effectiveness and safety of pharmacist-led inpatient anticoagulation therapy in comparison to standard or physician-managed care. Methods: This narrative review comprises papers sourced from a literature search of the PubMed, Embase, and International Pharmaceutical Abstracts databases, in addition to manual searches of the references from pertinent publications. Full articles of pharmacist-managed inpatient anticoagulation services were eligible if published in English and evaluated clinical outcomes. Results: Twenty-six studies were included and then classified into two categories: 1) autonomous pharmacist-managed anticoagulation programs (PMAPs) and 2) pharmacist recommendations. It seems that having a pharmacist manage heparin and warfarin leads to better results for some surrogate outcomes (international normalized ratio [INR] stability and time in INR goal range), but the results for others (time to therapeutic INR, length of stay, and activated partial thromboplastin time [aPTT] measures) are mixed. There is also some evidence that PMAPs may be linked to lower patient death rates. When pharmacists handle direct thrombin inhibitors, it seems like there is a shorter time to therapeutic aPTT, a higher proportion of time in the therapeutic range, and fewer prescription mistakes. Pharmacist recommendation services have typically led to a longer period in the therapeutic INR range, more stable INR levels, shorter hospital stays, and fewer serious medication interactions. There were no substantial variations in safety outcomes. Conclusion: Pharmacist-led inpatient anticoagulation therapy seems to provide better results than standard or physician-managed care. This result is constrained by tiny, inadequately conducted studies that lack statistical power and primarily concentrate on surrogate outcomes.