There currently exists relatively little published data for head-to-head comparisons amongst the low molecular weight heparins tinzaparin (Innohep), enoxaparin (Lovenox), nadroparin (Fraxiparin), and dalteparin (Fragmin). No health technology assessment reports, systematic reviews, or meta-analyses were located in this review. Amongst RCTs that were identified, one trial for prevention of VTE recurrence failed to identify a significant difference between outpatient treatments with tinzaparin or dalteparin. Studies pertaining to management of acute coronary syndromes may suggest differences of effectiveness amongst LMWHs, while two studies involving hemodialysis did not show signs of differences between LMWHs. Two RCTs in patients with unstable angina and spinal cord injury failed to identify differences between alternative LMWH preparations, though statistical power may have been particularly limited. More randomized studies comparing the effectiveness of the therapies in this class of agents in terms of clinically important outcomes are required to further inform choices made by physicians and hospital pharmacies.