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Thromboembolism remains a serious concern for women undergoing surgery for benign and malignant gynecologic conditions. Attempts at perioperative thromboprophylaxis have probably reduced the incidence of DVT considerably. Both heparin and mechanical devices offer effective and safe treatment. However, even though unfractionated heparin and LMWH compounds are easy to administer and are well tolerated by patients, mechanical compression devices avoid the bleeding complications that may be encountered with anticoagulation therapy. Individual patient risks and circumstances should be taken into consideration when choosing which therapy to use (Table 1). Those patients at greatest risk may benefit from aggressive combination therapy.