Multiple risk factors – venous stasis, dehydration, inflammation, immobility, and imbalances in pro-thrombotic and anti-thrombotic factors – predispose surgical patients to postoperative pulmonary embolism (PE). The incidence of PE varies with the type of surgical intervention and its indication. A thorough understanding of the clinical and anatomical aspects of an intervention that predispose to thrombosis is vital for surgeons to optimize patient outcomes. Pulmonary embolism has a heterogenous clinical presentation. Classical features of a PE may be difficult to discern in the postoperative period, and the diagnosis becomes challenging in sedated or mechanically ventilated patients. This is especially true after abdominal or thoracic interventions where postoperative symptoms can mimic those of PE. The diagnosis is based on clinical and radiological assessments. A high index of suspicion is necessary to ensure timely diagnosis and management. Multiple societies have made significant efforts to standardize peri-operative prevention. Prophylaxis recommendations must balance patient-related and operation-related risks for venous thromboembolism against the potential for bleeding complications. The mainstay for managing a postoperative PE is systemic anticoagulation if the bleeding risk is acceptable. However, catheter-directed interventionsCatheter-directed interventions have also become increasingly utilized over the past decade. Suction thrombectomy without the use of lytic agents is particularly attractive as it is minimally invasive, effective, and safe in cases of high bleeding risk. Veno-arterial extracorporeal membrane oxygenation (ECMO) can be pursued in case of impending circulatory collapse. This chapter summarizes the epidemiology, clinical presentation, diagnosis, and management options for PE after abdominal and thoracic operations.