<p>This study aimed to evaluate the clinical presentation and outcomes of patients with saddle pulmonary embolism (SPE) undergoing pharmaco-mechanical thrombolysis, highlighting the role of specialized multidisciplinary care. This retrospective study describes a series of cases in a Mexican tertiary care hospital with a newly established Pulmonary Embolism Rapid Response Team (PERT). The study took place in a tertiary care hospital in Mexico. Patients or participants: Twelve patients diagnosed with saddle pulmonary embolism were included in the study. All patients underwent catheter-guided thrombolysis and fragmentation as part of their treatment. The main variables of interest included clinical presentation, hemodynamic stability, and outcomes following catheter-directed therapy. Catheter-guided thrombolysis and fragmentation led to significant hemodynamic improvement in all patients. The intervention, combined with standard anticoagulation, showed promise in stabilizing hemodynamics and reducing thrombus burden, potentially improving outcomes in patients with SPE. Specialized multidisciplinary care, as provided by a Pulmonary Embolism Rapid Response Team, is crucial in managing saddle pulmonary embolism. The study offers insights into the safety and efficacy of endovascular interventions in this patient population.</p>