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Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): CHU Toulouse Rangueil Background Venous thromboembolic disease is a common cardiovascular disease, but long-term data on patient survival according to mid-term symptoms are scarce. Objective To describe outcomes (mortality and functional status) of pulmonary embolism (PE) 5 years after a first inaugural symptomatic episode of acute PE according to symptoms persistence at 6-months. Methods 137 patients with acute symptomatic PE were consecutively recruited at a French University Hospital from 2015 to 2017. Clinical characteristics were compared at 5-years between patients with persistent respiratory symptoms and asymptomatic patients at 6-month. Telephone collection of vital status, recurrence of VTE, NYHA score, current treatment, bleeding events as well as follow-up provided by a specialist were carried out in March 2022 on 105 patients (11% were lost of follow up). Results Patients were predominantly male (n=63, 57.5%) 60.2 yo. PE was initially classified at low, intermediate low, intermediate high and high risk respectively in 42.8, 25.7, 30.5 and 1%. 60 patients (57%) were symptomatics at 6 months. At 5 years, survival was 87.1% with a 17.7% recurrence rate regardless of initial PE presentation and severity, and 50% of patients remain symptomatic. Age, hypertension, diabetes, renal failure, obesity and the existence of a psychiatric pathology are associated with a higher mortality at 5 years. The survival and recurrence of MTVE at 5 years are similar between symptomatic or asymptomatic status at 6 months but symptomatic patients at 6 months are twice as many symptomatic at 5 years than asymptomatic patients at 6 months. Conclusion After an inaugural acute symptomatic PE is 5-year survival was 87%. Age, obesity, diabetes, renal failure, hypertension and the existence of an underlying psychiatric pathology are associated with a poorer prognosis at 5 years. The persistence of symptoms at 6 months of PE was not correlated with survival or recurrence of VTE at 5 years but at the persistence of symptoms at 5 years.