Incidence of PE in pts with DVT was 30%, 17 % of them were asymptomatic. Clinical assessment is important, but absence of symptoms and signs suggestive of PE can not exclude it. V/Q lung scan is recommended as an initial screening test for PE in patients with DVT that can excellently exclude PE. Meanwhile, echocardiography plays a major role in ICU patients. Pulmonary angiography is a safe procedure and should be performed in any doubted case before subjecting patients to IVC filter insertion.