An algorithm to guide management of patients with disseminated intravascular coagulation (DIC). If patients with an underlying condition known to predispose to DIC present with bleeding such as trauma-related or obstetrical DIC, predominance of hyperfibrinolysis over procoagulant process is anticipated, and administration of tranexamic acid along with blood product support should be the first step. Once bleeding has been controlled, consideration should be given to anticoagulant treatment to control the ongoing thrombin generation. On the other hand, in procoagulant DIC, where bleeding is not an initial presentation, anticoagulation is considered first and blood product support only if bleeding occurs or interventional procedures are required. *Blood tests (complete blood count, clotting screen, serum fibrinogen, and D-dimer) should be done every 6 to 8 h until they are stable or improving. **Low-molecular-weight heparin (LMWH) should be considered if there is laboratory evidence of DIC and the patient is not bleeding. Since other anticoagulants such as antithrombin and thrombomodulin are awaiting validation studies, these agents should be considered in the trial setting. ***Blood product support is with platelet transfusions, cryoprecipitate or fibrinogen concentrate, and fresh frozen plasma in that order.