Rivaroxaban is an oral anticoagulant medication, commonly known by the brand name Xarelto, that functions as a direct factor Xa inhibitor to prevent and treat blood clots. It effectively blocks the clotting protein factor Xa, interrupting the coagulation cascade without requiring antithrombin or routine monitoring like warfarin, offering predictable anticoagulation with fewer dietary restrictions. Medical uses include reducing stroke risk in nonvalvular atrial fibrillation, treating deep vein thrombosis and pulmonary embolism, prophylaxis after hip or knee surgery, and lowering cardiovascular risks in coronary or peripheral artery disease when combined with aspirin. Rivaroxaban provides advantages over older anticoagulants due to its oral administration, rapid onset of 2.5-4 hours, and selectivity for both free and clot-bound factor Xa. Available as tablets or suspension, it suits adults and certain pediatric patients for venous thromboembolism management post-Fontan procedure or in congenital heart disease.