The aim of this study was to assess the burden of PE, in terms of mortality and health-related quality of life (HrQoL), as a function of patient characteristics, across Europe. MethOds: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries (France, Italy, Spain, UK, and DACH (Germany, Switzerland and Austria)). Venous thromboembolism (VTE) patients, following an acute event (index event), were recruited and followed at 1, 3, 6 and 12 months. The study sample was 1399 patients with PE. Subgroup analysis by country and with active cancer were conducted. The association between patient characteristics and mortality/HrQoL (EQ-5D-5L) were examined using a regression approach with the total sample. Results: Average mortality rate at 12 months was 8.1%, varying between observed regions (1.4% in DACH to 16.8% in Italy), and substantially differed between patients with active cancer and those without (42.7% vs. 4.7%). Cancer was one of the most significant predictors for mortality, other predictors include age, BMI, more than 5 days bed rest, vascular disease, previous AF, smoking history and symptoms of palpitations. EQ-5D-5L index score at baseline (right after the index event) was 0.712 (SD: 0.265), and gradually improved to 0.835 (0.212) at 12 months. When scoring non-survivors at zero, average quality of life decreased to 0.743 at 12 months. Similarly, the index scores varied between observed countries and cancer subgroups. Active cancer, previous stroke and provoked VTE are amongst other significant factors for predicting index scores. cOnclusiOns: PE is associated with a substantial burden of illness -increasing mortality rate and decreasing HrQoL. Country variation exist and active cancer has a significantly large impact on PE burden.