Pulmonary embolism (PE) is a potential fatal disorder. It is the blockage of one of the pulmonary arteries in the lungs. In most cases, blood clots are the reason for the block and often, more than one clot is involved in causing the block. The clot often originates from the deep veins of the lower limbs, a condition known as deep venous thrombosis (DVT). The most common clinical manifestations in PE includes sudden onset dyspnea, tachypnea, pleuritic chest pain, cough and hemoptysis. Clinical findings that should raise the suspicion to PE are, lower leg pain or swelling, pleuritic chest pain, dyspnea and elevated D-dimers on blood tests (although not very specific for the disease, but a negative D-dimer would virtually exclude PE as a likely diagnosis). The challenge for the doctors working in the emergency room, can be to recognize the clinical presentation of a PE, as the symptoms often are non-specific. Unrecognized PE can potentially have fatal effects for the patient. The treatment is aimed at keeping the clot from becoming bigger and prevention of new clot formation. The mainstay of treatment of PE is anticoagulation whereas the most commonly used are heparin subcutaneous or intravenous, oral anticoagulants (warfarin) and new oral anticoagulants (NOAC). This is why recognition, combined assessment and intervention is of utter importance for the overall outcome.