Objective: This study was conducted to define global rate of patients at risk of venous thrombo-embolism (VTE) by type of acute illness (medical/surgical), to define factors driving prophylaxis decision in medical and surgical patients, to compare prescription modalities v/s international guidelines (ACCP) 2008, and to determine the proportion of at risk hospitalized patients who receive effective types of VTE prophylaxis.   Methods: This study was a cross sectional, observational study, conducted in medical and surgical wards. Recruitment was carried over nearly one year. Four hundred ninety five patients (495) were enrolled, 235 surgical patients aged 21 years or older undergoing an operation which requires general  or epidural anaesthesia lasting at least 45 min and 260 medical patients aged 40 years or older admitted for treatment of acute medical illness. Patients were evaluated during a single visit.   Results: Out of 495 patients, 292 patients (59%) were males and 203 patients (41%) were females, the age range was between 21 and 93 years in the surgical group compared to between 40 and 90 years in the medical group, the mean ages were 59.28±12.51 in the medical group compared to 51.91±14.44 in the surgical group, the percentage of patients at risk of VTE was (88.9%) in the medical population and (3%) in the surgical population, the most frequent risk factors in the medical population were acute infection (30.8%), obesity (30%), central venous catheter (29.2%), chronic pulmonary disease (21.9%), long term immobility (21.9%), chronic heart failure (21.2%) and acute respiratory failure (19.6%).   The most frequent risk factors in surgical population were obesity (38.3%), malignancy (24.3%), central venous catheter (20%), long term immobility (16.2%), chronic heart failure (16.2%), acute infection (8.9%), chronic pulmonary disease (8.9%) and cancer therapy (4.3%).   The most common types of anticoagulant prophylaxis received by both medical and surgical population were low molecular weight heparin (91.4%) and vitamin K antagonist (3.4%).   Conclusion: VTE is a major public health issue. It is a preventable disease with a substantial risk of morbidity and mortality in patients hospitalised for acute medical and surgical conditions. Our data has shown that a large proportion of hospitalised individuals both surgical and medicalare at risk for VTE. Hospital-wide strategies to assess patients' VTE risk should be implemented, together with measures that ensure that at-risk patients receive appropriate VTE prophylaxis.