Pulmonary embolism (PE) is a life-threatening condition or complication and might be one of the worst nightmares for most surgeons.The aim of this study was to evaluate the incidence of venous thrombo-embolism (VTE) in patients undergoing major abdominal surgery and major orthopedic surgery who received VTE prophylaxis.Methods: Between January of 2010 and September of 2013 all the patients who underwent major abdominal surgery and major orthopedic surgery who received VTE prophylaxis, at King Fahad Hospital Dammam Kingdom of Saudi Arabia, were prospectively evaluated for the incidence of DVT and PE within 30 postoperative days.Results: The incidence of symptomatic DVT and PE in the patients studied was 2.23% and 2.03%, respectively. The incidences of PE and DVT following abdominal surgery were 2.44%, and the incidences of PE and DVT following orthopedic surgery were 1.62% and 2.03%, respectively.Conclusion: Despite the use of thromboprophylaxis, PE and DVT were important complications of major abdominal and major orthopedic surgery.