Introduction: Pulmonary thromboembolism (PTE) and Deep vein thrombosis (DVT) are common complication following any type of surgery. Orthopedic surgeries have a risk higher than 10% of developing PTE. Therefore, a 2 to 5 weeks is given after the surgical procedure. The Aim: of this study was to present a case of PTE, preceded by local DVT, preceded by orthopedic surgery despite of prophylaxis with 4000 I.U of LMWH for 21 days and the 1year outpatient follow up afterwards. Materials and Methods: A full clinical analysis of a 20 years-old male athlete treated for PTE, DVT and Pleuropneumonia from 22.06.2024 to 05.07.2024 in inpatient setting and a follow up treatment in outpatient setting for 1 year. Results: The patient was admitted with d-dimer count of 3900ng/L, S1Q3T3 ECG pattern highly suspected of underlying PTE. What followed was 2 week long inpatient treatment and stabilization and 1 year-long outpatient treatment, evaluation and finally permanent discontinuation of anticoagulant therapy. Discussion: In an inpatient setting the treatment with LMWH is safer than any other type of anticoagulation for PTE when the right conditions are met and no imminent hemodynamic instability is present. DVT and PTE remain common complications of surgeries especially orthopedic ones. Conclusion: This case highlights the importance of circulatory complications related to surgeries, especially orthopedic ones and how sometimes the given prophylaxis can fail.