OBJECTIVE:To highlight the usefulness of apixaban on intra-atrial thrombus that develops after previous treatment with warfarin. CLINICAL PRESENTATION AND INTERVENTION:A 69-year-old woman with a history of atrial fibrillation treated with warfarin presented with acute decompensated heart failure due to an episode of atrial fibrillation. Transesophageal echocardiogram revealed the presence of an intra-atrial thrombus. She was treated with apixaban, and transesophageal echocardiogram showed complete resolution of the thrombus after 3 weeks of treatment. CONCLUSION:This case highlights the usefulness of apixaban in the management of atrial fibrillation and proven intra-atrial thrombus.