Objectives: This investigation characterizes the demographic characteristics of the patients attending a pharmacist managed anticoagulation clinic in the resource-constrained setting of western Kenya and outlines the challenges of delivering an anticoagulation monitoring service in this setting Methods: Through the collaboration of Purdue University College of Pharmacy faculty and local Kenyan pharmacists, a contextualized anticoagulation clinic care model has been developed which incorporates community health workers, pharmacy technologists, and physicians to deliver protocol-based care. Through the collection of data on standardized encounter forms, the initial demographic characteristics of this population are described. Results: The unique mix of indications for anticoagulant therapy of the 83 patients enrolled thus far can be seen as 9.6% have artificial heart valves, 18.0% have rheumatic heart disease induced valvular changes, and 59.0% have deep vein thrombosis or pulmonary embolism. Several setting specifi c challenges have been identifi ed including the potential for drug interactions with warfarin due to concomitant therapies for disease states such as tuberculosis and Human Immunodefi ciency Virus (HIV). Conclusions: With the increased awareness of the growing burden of diseases requiring anticoagulation therapy in sub-Saharan Africa, there is an emerging need for anticoagulation infrastructure in the context of provision of health care in western Kenya.