AIM: To analyze the clinical characteristics of anticoagulant rat poisoning and vitamin K1 to improve clinical diagnosis and treatment. METHODS:  The clinical data of 51 patients hospitalized in the emergency department of our hospital from January 2020 to December 2022, including poisoning mode, poisoning time (poison exposure to admission time), clinical manifestations, coagulation function, vitamin K1 dosage and treatment results, etc. All patients were followed up for 3 months. RESULTS: Among the 51 patients, 27(52.94%) were toxic, the highest proportion. PT, APTT, and INR improved significantly at discharge compared to admission (P<0.01). Twenty three patients had bleeding symptoms during admission, PSS score: 12 mild, 7 moderate and 4 severe; Forty six patients with clear history of toxic exposure were divided into 48 h and <48 h groups according to the poisoning time. By comparison between the two groups, the difference was significant (P<0.01). Twenty eight patients had abnormal coagulation function on admission, which was divided into 12 and 16 in 40 mg/d and > 40 mg/d and a long time in 40 mg/d group, but not statistically significant (P>0.05). CONCLUSION: The symptoms of anticoagulant rat dose poisoning are coagulation dysfunction and bleeding; the prolonged coagulation abnormality is more significant; the larger dose of vitamin K1 is not significantly different than the normal dose, and the timeliness and maintenance time of vitamin K1 treatment are more important.