Deep vein thrombosis (DVT) is the third most common cardiovascular disease worldwide but traditional anticoagulation therapy options are limited. The pathophysiology of DVT usually focuses on Virchow’ s triad, but this fails to explain many of the clinical problems. Considering the interactions of metabolic reprogramming with inflammation and coagulation may thus open up new perspectives. This review explores the roles of the metabolic microenvironment in thrombosis and oxidative stress in relation to metabolic reprogramming and thrombosis, analyzes the feedback loop between metabolic reprogramming and inflammatory coagulation, and summarizes the therapeutic strategies of metabolic regulation intervention in DVT, including glucose metabolism, lipid metabolism, and antioxidant therapy. We also highlight the challenges in terms of therapeutic strategies, and indicate potential new approaches to the prevention and treatment of DVT.