Dengue hemorrhagic fever presents as a management challenge in patients requiring concurrent dual antiplatelet therapy (DAPT), anticoagulation and statins. Similar scenarios are profuse in endemic regions like Kandy, Sri Lanka. We present two cases of Dengue Hemorrhagic Fever (DHF) in similar context which was managed based on thorough literature review which suggests that, while DAPT and anticoagulation may need to be discontinued in severe thrombocytopenia, statins can often be safely continued under close monitoring. We highlight the advanced management guidelines for similar complex clinical scenarios that need to balance thrombotic and bleeding risks, as in DHF. Local guidelines which address specific similar context are lacking and this narrative review highlights the need to develop evidence-based recommendations.