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Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. The managementof patients using antithrombotic agents and requiring gastrointestinal endoscopy is an important clinical challenge. Althoughclinical practice guidelines (CPGs) for the management of patients receiving antithrombotic agents and undergoing gastrointestinalendoscopy have been developed in the Unites States, Europe, and Asia Pacific region, it is uncertain whether these guidelines canbe adopted in South Korea. After reviewing current CPGs, we identified unmet needs and recognized significant discrepanciesin the clinical practice among regions. This is the first CPG in Korea providing information that may assist endoscopists in themanagement of patients on antithrombotic agents who require diagnostic or elective therapeutic endoscopy. This guideline wasdeveloped through the adaptation process as an evidence-based method, with four guidelines retrieved by systematic review. Eligibleguidelines were evaluated according to the Appraisal of Guidelines for Research and Evaluation II process, and 13 statements wereestablished using a grading system. This guideline was reviewed by external experts before an official. It will be revised as necessaryto cover changes in technology, evidence, or other aspects of clinical practice.