Recurrent spontaneous abortion (RSA) is defined as the loss of at least two consecutive pregnancies before the 28th week of gestation. RSA is a complicated pathological condition causedmultiple factors including genetic abnormalities, anatomical factors, endocrine disorders, immune abnormalities, prethrombotic state (PTS) and infection factors. Studies have suggested that anticoagulation and antiplatelet therapy could significantly improve the pregnancy outcomes of RSA patients with PTS and autoimmune abnormalities. Frequently used anticoagulants and antiplatelet drugs are heparin, heparinoid, warfarin, aspirin and clopidogrel. However, the maternal and fetal safety after the of these drugs during pregnancy has long been concerned. Safety of anticoagulants and antiplatelet drugs in patients with recurrent spontaneous abortion during pregnancy is reviewed.