Objective：To analyze the anticoagulant effect of rivaroxaban and warfarin on cerebral venous sinus thrombosis. Methods：A total of 52 patients with cerebral venous sinus thrombosis admitted to the Third People’s Hospital of Bengbu from February 2018 to February 2022 were selected as the research objects，and were divided into observation group（n=25） and control group （n=27） according to different anticoagulant drugs. The observation group was given rivaroxaban for anticoagulation treatment，and the control group was given warfarin for anticoagulation treatment. The results of international normalized ratio （INR） and activated partial thromboplastin time （APTT） and the occurrence of bleeding and embolism complications during treatment were analyzed and compared between the two groups for 3 months after anticoagulation treatment，so as to study and compare the anticoagulation efficacy of drugs in the treatment of cerebral venous sinus thrombosis between the two groups. Results：The results of INR and APTT were （1.4±0.3） s and （40.1±2.5） s respectively in the observation group after 3 months of anticoagulant treatment，which were lower than those in the control group （2.5±0.7） s and （42.3±4.0） s，the difference was statistically significant （P<0.05）. One case of skin and mucous membrane hemorrhage occurred in the observation group. The incidence of bleeding complications in the observation group was lower than that in the control group，and the difference was statistically significant （P<0.05）. There were one case of ischemic cerebral infarction in the observation group and three cases of ischemic cerebral infarction in the control group，as well as one case of severe pulmonary embolism and one case of deep venous thrombosis of lower limbs. The incidence of venous and arterial embolization adverse events was lower than that of the control group，but the difference was not statistically significant （P>0.05）. Conclusion：The rivaroxaban drugs in the treatment of cerebral venous sinus thrombosis，clinical effect is significantly better than that of warfarin anticoagulant drugs to have a lower incidence of bleeding，the rivaroxaban anticoagulant thrombosis appeared in the process of adverse events and warfarin had no significant differences，these make it on in the treatment of cerebral venous sinus thrombosis in clinical effect is better than drug warfarin.