Abstract Coagulopathies are common in intensive therapy units (ITUs) and may represent both the cause and the consequence of a critically ill status. Because coagulopathies are associated with increased complications in terms of both increased ischemic and bleeding events, the prevention, assessment, and treatment of these clinical conditions are important issues to be considered in the ITU. In this review, we explore the pathophysiological mechanisms, discuss the most common causes, and provide practical recommendations on the assessment and treatment of coagulopathies in the ITU.