The use of thrombolytic agents in the treatment of hemodynamicallystable patients with acute submassive pulmonary embolism remainscontroversial.We conducted a study of patients with acute pulmonary embolismand pulmonary hypertension or right ventricular dysfunction but withoutarterial hypotension or shock.Half of the patients received conventional anticoagulation in theform of therapeutic dose of Enoxaparin sodium (Clexane). The other halfreceived streptokinase with bolus initializing doze 250000 IU over 30minutes then maintenance dose 100000 IU every hour for 24 hours bycontinuous infusion.All patients were primarily assessed before either treatment,monitored in ICU all through the process then all investigations wererepeated I weak later except CTPA repeated 3 months later.