Recently some key papers and consensus have shed some new light on antiphospholipid syndrome (APS). Concerning the tests the search for lupus anticoagulant is now better defined. A modified antibeta2-glycoprotein I assay has been shown to be more specific for clinical complications. It seems necessary to still perform anticardiolipin antibodies in case of pregnancy morbidity but not in case of thrombosis which raises the question of two separate clinical entities with different pathologic mechanisms. Concerning the pathophysiology, new data emphasize the role of complement and underscore the role of genetic predisposition. The data of some large cohort followed prospectively such as the European cohort (1000 APS patients) as well the data of some registries (APS in children and patients with a catastrophic APS) bring some new important information on the clinical aspects of the syndrome. Finally this review will propose some algorithms to treat patients with APS.