The first management guidelines in the field of venous thrombosis, European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis was published in the European Journal of Vascular and Endovascular Surgery in 2021. The guidelines address acute deep vein thrombosis (DVT) of the lower extremity, upper extremity DVT, superficial vein thrombosis (SVT), and thrombosis in unusual sites, with a total of 72 recommendations. In addition to treatment-related recommendations, the guidelines also cover topics such as health economics and special patient populations. The recommendations in the guidelines have been formulated by analysis and evaluation of the available scientific evidence, and may have great referential value for clinical work. However, as technology, available evidence and disease knowledge continue to advance, the guidelines may need to be updated regularly. Here, the author's team emphatically interprets the recommendations given in the guidelines based on the medical evidence updated in the guidelines and combined with the hot issues in clinical practice, so as to better understand the guiding principles and practical recommendations.