Objectives: The objective was to determine who will benefit most from oral anticoagulation (OAC) for non-valvular atrial fibrillation (NVAF) patients aged >= 75 years. Background: It was unclear whether all of NVAF aged >= 75 should receive OAC. Methods: We recruited NVAF >= 75 years without QAC who were divided into three groups according to CHA(2)DS-VASc scores. The clinical endpoints were ischemic stroke (IS), thromboembolism (TE), or death. Results: The patients with CHA(2)DS(2)-VASc score of 6-9 were not appropriate for anticoagulation with the highest HAS-BLED scores. CHA(2)DS(2)-VASc of 2 had little risk for IS/TE. We further divided CHA(2)DS(2)-VASc of 3-5 into three subgroups with estimated glomerular filtration rate (eGFR; ml/min/1.73 m(2)): < 30, 30-60, and > 60. The patients with eGFR < 30 had the highest bleeding risk with a comparable IS/TE. Conclusions: NVAF with CHA(2)DS(2)-VASc of 3-5 and eGFR > 30 ml/min/1.73 m(2) represent the most appropriate population for anticoagulation.