1. Dermatan sulfate is a linear, sulfated polysaccharide and is a glycosaminoglycan component of several important proteoglycans. This minireview discusses the biosynthesis, structure and biological function of dermatan sulfate proteoglycans. 2. Dermatan sulfate and its derivatives are being investigated as a new class of anticoagulant and antithrombotic agents. 3. The preparation, chemistry and structure-activity relationship of dermatan sulfate is described. 4. Dermatan sulfate, low molecular weight dermatan sulfate and glycosaminoglycan mixtures containing dermatan sulfate have been used clinically. 5. The future prospects of these agents and other new, potentially useful dermatan sulfate based therapeutics are discussed.