Acute pulmonary embolism is a common condition that can cause shock when large volume, and emergency surgical embolectomy has a role in the treatment pathway. Guidelines for management of pulmonary embolism suggest that emergency surgery is indicated for high-risk patients that are haemodynamically unstable. Through the use of cardiopulmonary bypass, clot retrieval can be performed safely and reproducibly. The management of such patients in the modern era utilises multidisciplinary Pulmonary Embolism Response Teams (PERT) for optimal outcomes.