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Objectives: The aim of this study was to evaluate possible variations in clinical risk factors and anatomopathological findings in fatal pulmonary embolism in relation to sex and age., Methods: The total sample consisted of 230 subjects (mean age 72 +/- 11 years), 103 males and 127 females, of which 74 died out-of-hospital and 156 in the course of hospitalization. 124 cases were then considered also separately as "sudden death group". The sample was stratified by sex and into 4 groups by age: subjects aged less than 60 years, between 60 and 69, between 70 and 79, and more than 80 years., Results: Age at occurrence of pulmonary embolism was significantly higher in females, compared with males (75 +/- 11 vs 69 +/- 11 years, p < 0.001), and the men/women ratio was higher in younger age groups, tending to inversion with aging. An increased frequency of males was found between subgroups of subjects affected by valvular heart disease (10.6% vs 2.3%, p = 0.019), and chronic pulmonary disease (7.7% vs 1.8%, p = 0.049), whereas an increased frequency of women was found in a group of subjects suffering from trauma or fracture (12.6% vs 2.9%, p = 0.016). As concerns age subgroups, a significant increased frequency of subjects aged < 60 years was found in risk groups "surgery" (36%, p < 0.001) and "malignancy" (40%, p = 0.002). Moreover, in subjects aged less than 80 years, main predisposing factors were recent trauma and/or a fracture (16.2%, p = 0.013)., Conclusion: The difference in frequency of risk factors between sexes could depend on the higher life expectancy in women, with consequent increase in likelihood of risk factors specifically related to the elderly.