Pulmonary thromboembolism is perhaps one of the most challenging diseases to recognize, diagnose, and treat appropriately in medicine today. Although the clinician is offered a variety of diagnostic modalities, a highly sensitive and specific diagnostic modality without significant risk does not yet exist. The newer noninvasive tests may offer valuable alternatives to the more invasive venogram and pulmonary angiogram. Figure 1 offers an algorithm for the diagnosis and management of thromboembolic disease. Failure to diagnose this entity can result in significant patient morbidity and mortality. Physicians must maintain a high index of suspicion as well as have an organized approach to diagnosis and management to improve survival of patients with thromboembolic disease.