Oral anticoagulation in patients presenting with non-valvular atrial fibrillation and a CHA(2)DS(2)-VASc score of 1 (CHA(2)DS(2)-VASc of 2 in women) remains a challenging approach in clinical practice. Therapeutic decisions need to balance the individual benefit of reducing thromboembolic risk against the potential harm due to an increase in bleeding risk in this intermediate risk patient population. Within the current opinion statement of the European Society of Cardiology working group of cardiovascular pharmacotherapy and the European Society of Cardiology council on stroke the currently available evidence on the anti-thrombotic management in patients presenting with a CHA(2)DS(2)-VASc of 1 is summarized. Easily applicable tools for a personalized refinement of the individual thromboembolic risk in patients with atrial fibrillation and a CHA(2)DS(2)-VASc score of 1 that guide clinicians through the question whether to anticoagulate or not are provided.