OBJECTIVES: Limited evidence is available regarding pharmacist managed anticoagulation clinic (PMAC) in the Southeast Asian region where there is marked difference in terms of care model, genetic composition and patient demographics. This study aimed at comparing the anticoagulation clinic managed by the pharmacist with physician advisory and the usual medical care provided in Kuala Lumpur Hospital (KLH) in terms of anticoagulation control and adverse outcomes. METHODS: A 2302 bedded government tertiary referral hospital in Malaysia. A 6-month retrospective cohort study of the effectiveness of 2 models of anticoagulation care, the pharmacist managed anticoagulation clinic (PMAC) and usual medical clinic (UMC) in KLH was conducted, where a random number generator was used to recruit patients. The UMC patients received standard medical care where they are managed by rotational medical officers in the Physicians’ Clinic. As for the PMAC with physician advisory, the pharmacist will counsel and review the patients Internationalised Normalization Ratio (INR) at each clinic visit and also adjust the patients’ warfarin dose accordingly. Patients are referred to physicians if immediate attention is required. The main therapeutic outcome is time in therapeutic range both actual and expanded TTR and thromboembolic and bleeding complications. RESULTS: Each of the PMAC and usual medical care recruited 92 patients, which totals to 184 patients. The patient demographics in terms of age, race and indication of treatment were comparable. At the end of the 6 months follow-up, patients in the PMAC group had significantly higher actual-TTR (65.1% vs. 48.3%; P<0.05) compared to those in usual medical care group. Rates of bleeding incidences were 6.5 versus 21.7 events per 100 person-years for the PMAC and UMC groups, respectively.  CONCLUSIONS: PMAC provided a significantly better anticoagulation care than usual medical care. The PMAC with physician advisory has been successfully implemented in Kuala Lumpur Hospital.