There are a number of therapeutic options for the prevention of stroke (primary or recurrent) or other thrombotic events in antiphospholipid antibody-positive individuals, although none is of proven benefit. Control of modifiable vascular risk factors and avoidance of thrombogenic drugs should be recommended for all persons with antiphospholipid antibodies, whether symptomatic or not. Therapies to prevent thrombosis include antiplatelet agents and anticoagulants, with warfarin the preferred choice in high risk patients who have recurrent events. Immunebased therapies, including plasma exchange, immunoglobulins, corticosteroids and immunosuppressants, are alternative treatment modalities for patients who have recurrent events despite receiving high-dosage anticoagulants.