There are very few guidelines, trials, or prospective management studies dedicated to management of anticoagulation for pulmonary embolism in the perioperative period, as many of these studies have centered around anticoagulation management in atrial fibrillation. Guidelines for peri-procedural interruption of oral anticoagulants are based on the broader aspect of venous thromboembolism which includes deep vein thrombosis and pulmonary embolism and generally have weak recommendations or suggestions based on the paucity of robust studies. Periprocedural bridging for warfarin interruption has no significant randomized trials and large heterogeneity in the observational trials but does show a trend toward more bleeding with low molecular weight heparin bridging without a clear signal of benefit. Interruption and resumption of direct oral anticoagulants timing is based on pharmacokinetics and extrapolation from atrial fibrillation prospect management study. The utility of direct oral anticoagulant levels is not readily available in most institutions and is rarely needed, and traditional tests like the prothrombin time and activated partial thromboplastin time are not predicative of direct oral anticoagulant levels. Use of normal antifactor Xa assays for heparin or low-molecular weight heparin for anti-Xa direct oral anticoagulants and the thrombin time for dabigatran are more available and are likely useful to rule out the presence of important drug levels. Use of inferior vena cava filters lack studies in the periprocedural space and are rarely indicated except for special circumstances when anticoagulation interruption must be done close to the occurrence of an acute deep vein thrombosis or pulmonary embolism.