Pulmonary thromboembolism is a fatal cardiopulmonary disease with a dangerous onset. Over the years, the research on the prevention and treatment of PTE in China has developed rapidly, and the awareness and level of diagnosis and treatment of physicians have been greatly improved. Due to the lack of characteristic clinical manifestations diagnosis is difficult, however, there are still problems of misdiagnosis, underdiagnosis and overdiagnosis. The vast majority of PTE is associated with venous thromboembolism (VTE) deep vein thrombosis, leading to thrombus dislodgement. The pathogenesis is associated with both genetic and acquired factors. For example, congenital defects in both coagulation and anticoagulation systems can increase venous thrombosis by more than 10-fold, with protein C defects, causing thrombosis accounting for 2% to 5% of the incidence, and up to 10% to 15% in younger patients, with DVT occurring in 100% of those with protein C defects, indicating the close relationship between the two. Protein S defects, accounting for 0.1% of DVT in the population, account for 5% to 6% of the total incidence of DVT. In western countries, the detection rate of protein C, S and/or antithrombin deficiency in VTE patients is 10%-15%, while the detection rate in Han Chinese VTE patients in China is significantly higher, 30%-55%, especially protein S deficiency is common, which is different from western protein C deficiency, and needs to be further studied carefully. In addition, acquired factors of patients should not be ignored, such as age, history of VTE, malignancy, post-surgical braking, neurological diseases with lower limb paralysis, long-term bed rest, hormone replacement therapy and contraceptive pill use. The Journal of Cardiopulmonary Vascular Diseases recently published an article by Xiu-Rong Wang et al. analyzing 56 cases of pulmonary embolism occurring in different clinical departments. For example, 24 cases occurred in surgical departments such as orthopedics, general surgery, neurosurgery, obstetrics and gynecology, and internal medicine mainly focused on cardiology and neurology. Of particular importance is that the incidence of postoperative DVT is related to the type of surgery. The incidence of PTE was reported to be 19% in general surgery, 24% in elective neurosurgery, 51% in hip orthopedics, and 61% in knee orthopedics. The incidence of postoperative DVT was also related to the age of the patient, the degree of trauma, and the duration of surgery and postoperative braking. The article emphasizes that patients have atypical clinical symptoms and are prone to misdiagnosis and underdiagnosis. There were 20 deaths among suspected and confirmed cases, accounting for 35.6% of the total cases. It fully proves the aggressiveness of the disease, suggesting that it is an interdisciplinary disease and that medical personnel from all disciplines should be alert to the disease and follow the ACCP guidelines for the prevention of deep vein thrombosis to prevent the application of anticoagulation therapy and avoid the tragedy of sudden death. Another misconception needs to be emphasized here. That is, the patient with respiratory distress or sudden death is wrongly considered as “pulmonary embolism”. I have participated in many emergency consultations and found that some patients with pulmonary edema due to fluid overload, dyspnea due to drug allergy, or cardiac insufficiency due to cardiac disease are treated as “pulmonary embolism”, and some primary medical staffs are unable to do relevant examinations and further identification due to the limitation of similar cases. Some primary medical staffs, when they encounter similar cases, are unable to do the relevant examination and further identification due to the limitation, and give thrombolysis or anticoagulation, which leads to hemorrhage or even life-threatening. If necessary, we must explain the condition to the family or the person concerned and weigh the pros and cons. On October 30, 2008, the European Society of Cardiology (ESC) published new guidelines for the diagnosis and treatment of acute pulmonary embolism (PE), which recommend that patients with suspected venous thrombosis should be evaluated for the possibility of PE. Two scoring systems, Geneva and Wells, have good predictive value for PE or deep vein thrombosis. These two scoring systems classify the likelihood of PE or DVT as low, moderate, or high by assessing the patient’s clinical presentation and risk factors. Patients are at high risk when they present with clinical manifestations of shock or hypotension, with or without echocardiographic (UCG) evidence of right ventricular insufficiency or elevated troponin; patients are at intermediate risk if they do not have clinical manifestations of shock or hypotension, but UCG suggests right ventricular insufficiency and/or elevated troponin levels; if patients do not have clinical manifestations of shock or hypotension and do not also have UCG evidence of right ventricular insufficiency or elevated troponin levels, they are at intermediate risk; if patients do not have clinical manifestations of shock or hypotension and do not also have If the patient has no clinical manifestations of shock or hypotension, and there is no evidence of UCG of right ventricular insufficiency or elevated troponin levels, the patient is at low risk. Ultrasonography of the lower extremities can be used as a means to confirm the diagnosis of DVT. In high- and intermediate-risk patients, UCG has important diagnostic and differential diagnostic value. It is especially valuable in emergency, critical care and during cardiopulmonary resuscitation. The guidelines state that in high-risk PE patients, if UCG suggests right ventricular insufficiency, a CT scan should be performed immediately. If the patient is too ill for a CT scan, empiric therapy can be started immediately. For high-risk patients with clinical suspicion of PE and positive CT scans, relevant therapeutic measures, including thrombolysis, should be given immediately; when patients with clinical assessment of suspected PE and positive multi-row CT scans, treatment for PE should be initiated; while those with negative multi-row CT do not require further investigation and treatment. For patients with low and moderate clinical suspicion of PE, D-dimer examination should be performed first, and PE treatment is not necessary for negative patients; for positive patients, further multilineage CT scans are required; for positive CT scans, PE-related treatment should be started; for negative patients, no treatment is required. Regarding the prevention and treatment of VTE, a comprehensive and three-dimensional program is needed to establish the concept of “prevention” as the main focus. The population groups that need to be strengthened for prevention are emphasized. They include: 1) patients with high-risk factors who undergo surgical procedures, especially those related to orthopedic joints; 2) patients in the acute phase of certain medical diseases, such as congestive heart failure, severe respiratory diseases, cerebrovascular diseases and those who require prolonged bed rest; 3) patients with high-risk factors in the ICU. According to ACCP guidelines, for patients undergoing surgical procedures, graded prophylaxis should be performed according to the age of the patient, the size of the procedure and risk factors: for high-risk patients aged 60 years, low-dose UFH (5000 Ubid) or LMWH >3400 U/day is recommended. In contrast, in very high-risk patients, including those with multiple risk factors or undergoing hip replacement, knee replacement, hip fracture or severe trauma, or spinal trauma, pharmacologic anticoagulation combined with mechanical prophylaxis, i.e., intermittent inflation compression device (IPC) or graduated compression compression stockings (GCS), is recommended. For patients who are medically able to be active and have a short hospital stay, no prophylactic medication is required to maintain activity. Low-dose undifferentiated heparin (LDUH) or LMWH should be started as early as possible in patients with intermediate risk factors, such as bedridden and very sick, until discharge; prophylactic LDUH or LMWH is recommended in patients who are bedridden due to underlying cardiopulmonary conditions (chronic congestive heart failure, severe respiratory disease, malignancy), if combined with other risk factors. most patients in the intensive care unit need to receive prophylaxis. For long-distance travelers, flights or sedentary periods longer than 6 hours, tight clothing for the lower extremities and lower back should be avoided, dehydration should be avoided, and activities such as gastrocnemius stretching should be performed frequently. Those with risk factors for VTE should consider GCS or pre-trip application of LMWH or pentosan sodium. Mechanical prophylaxis methods such as vena cava filters should be applied with caution and temporary filters are recommended when necessary and to ensure proper use and optimal compliance, mainly in patients at high risk of bleeding, patients at risk of fatal recurrent pulmonary embolism or as an adjunct to anticoagulation.