Abelacimab is a novel, first-in-class, fully human monoclonal antibody designed to inhibit factor XI (FXI) and activated factor XI (FXIa). Unlike conventional anticoagulants that target factor Xa or thrombin, Abelacimab aims to separate hemostasis from pathological thrombosis by selectively targeting the intrinsic coagulation pathway. By blocking FXI/FXIa, Abelacimab prevents the amplification of the coagulation cascade without significantly impairing primary hemostasis (platelet function). It is administered intravenously or subcutaneously and is currently under investigation for the prevention and treatment of various thrombotic disorders, including atrial fibrillation, venous thromboembolism (VTE), and in patients undergoing total knee or hip replacement.