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Venous thromboembolism (VTE), that is, formation of a blood clot within the venous system and subsequent embolisation, haunts every service in the hospital, and psychiatry is no exception. When arising in the deep veins of the lower extremities, these thrombi put patients at risk for potentially fatal pulmonary embolism (PE). Virchow’s well-known triad describes the three factors that influence thrombogenesis: (1) damage to the endothelial lining of the blood vessels, (2) stasis or turbulence of blood flow, and (3) blood hypercoaguability. Conditions that increase a patient’s risk of developing VTE include smoking, chronic obstructive pulmonary disease, congestive heart failure, pregnancy, cancer, inherited hypercoaguable states, inflammatory bowel disease, obesity, surgery, and history of previous VTE. Medical inpatients carry a 10% to 20% risk of developing clots in their deep veins, although only a portion of these occur in proximal locations most likely to embolize to the lungs. Deep venous thrombosis (DVT) occurs in about one per 1000 persons per year, and is the third most common reason for hospital deaths. Two-thirds of VTE occur as DVT alone, while one-third of the cases of VTE present as PE. Approximately 350,000 to 600,000 Americans each year suffer from DVT and PE, and at least 100,000 deaths may be directly or indirectly related to these diseases. Like healthcare-associated infections, PE is largely preventable when healthcare workers, including those in mental health, implement current recommendations for prevention, screening, and management. A recent review noted over 100 guidelines related to DVT and PE prevention, diagnosis, and treatment in general and specific populations. A risk assessment tool and management algorithm for psychiatric inpatient settings has been proposed to guide VTE prophylaxis. However, even in medical