Background: Antidotes appropriate for non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) are not yet in widespread clinical use. Efficacy of prothrombin complex concentrate (PCC) in NOAC-associated bleeding remains unclarified. Methods: Ten NOAC users (4 women, median 74 years old) who developed major bleeding and received PCC were prospectively enrolled. Eight single-center NOAC users (0 women, median 74 years old) with intracerebral hemorrhage, who over the same period did not receive PCC, were studied for comparison. Results: Of the 10 PCC-treated patients, 8 developed intracerebral hemorrhage, 1 developed subdural hematoma, and another developed gastrointestinal bleeding. The median size of intracerebral hemorrhage was 8 mL, relatively lower than the reported size for patients without NOACs. Patients received a median of 1000 IU or 16 IU/kg of PCC. Before and 1 h after PCC administration, the median PT-INR changed from 1.41 to 1.09 (p < 0.05) and median aPTT changed from 35.4 to 38.0 s (p = 039). Five patients developed intracranial hematoma expansion and 4 required surgical hematoma evacuation. No symptomatic thrombotic events occurred in either group, no participants died, and 2 participants from each group were independent. Conclusions: Ten NOAC users developed major bleeding and were given relatively low doses of PCC The effect of PCC on early cessation of bleeding was unclear, while the therapy did not trigger thromboembolic complications. (C) 2017 Elsevier B.V. All rights reserved.