Pulmonary embolism is a frequently fatal form of venous thromboembolism that is often avoided with the placement of an Inferior Vena Cava (IVC) filter. Although these filters have low complication rates, filter migration, caval occlusion, and filter fragmentation can occur. Filter strut perforation of the IVC lumen is a frequent occurrence and is typically asymptomatic. We report a case of filter fragmentation with subsequent strut migration and perforation, extending out of the IVC lumen and penetrating into the surrounding vascular and connective tissues as well as into the inferomedial aspect of the left lower lung lobe and the right atrium causing significant abdominal and back pain. The patient underwent operative retrieval of the filter.