OBJECTIVES: The aim of this study was to assess the prevalence of inappropriate prescribing of antithrombotic therapy in hospitalized elderly patients. METHODS: A retrospective cross-sectional, single-center study was conducted at the Gondar University Hospital (GUH). Hospitalized elderly patients aged ≥65 years with Congestive Heart Failure, Venous Thromboembolism, Stroke, Atrial Fibrillation, Acute Coronary Syndrome, Peripheral Valvular Disease, elderly patients with a known co-morbidity of cardiovascular diseases, patients with a history of coronary, cerebral or PVDs, and patients prescribed with any of antithrombotics were included in the study. The  STOPP/START  criteria version-2 was  applied  to  each  patients’ data to  identify  the total instances of Inappropriate Prescription (IP) including potentially inappropriate medications (PIMs),  potential  prescribing  omissions  (PPOs).  RESULTS: A total of 70 IPs were identified in 156 patients identified who fulfilled the inclusion criteria. Of which, 36 (51.4%) PIMs were identified by the STOPP criteria. The prevalence of IP per patient indicated that of the 156 patients, 58 (37.2%) were exposed to at least one IP. Of which, 32  (55.2%)  had  at  least  one  PIM  and  33 (56.9%)  had  at  least  one  PPO. Patients hospitalized due to VTE (AOR=29.87, 95% CI, 1.26-708.6), stroke (AOR=7.74, 95% CI, 1.27-47.29) or ACS (AOR=13.48, 95% CI, 1.4-129.1) were more likely to be exposed to an IP. An  increase  in  CCI  score  was  associated  with  reduced  IP  exposure (AOR= 0.60, 95% CI, 0.39-0.945). Patients prescribed with antiplatelet only therapy were about 6 times more likely (AOR= 6.23, 95% CI, 1.90 - 20.37) to have an IP than those with any other groups of antithrombotic. CONCLUSIONS: The findings indicate that inappropriate prescribing of antithrombotic therapy were common among hospitalized elderly patients. Our study may guide further research to reduce high-risk prescribing of antithrombotics in older people.