Pulmonary embolism (PE) in pregnancy is a significant cause of maternal morbidity and death. Factors such as older age, increasing incidence of obesity in the population, and higher use of assisted reproduction techniques have been associated with an increased incidence of PE in pregnancy. In this chapter, the pathophysiology, diagnosis, therapy, and prevention for pregnant patients with PE are reviewed. An exemplary case of intermediate high-risk PE with high-risk features in a patient in her second trimester of pregnancy is presented, illustrating the utility of advanced therapy.