Deep vein thrombosis arising from the pelvis and lower extremity veins represents the source of pulmonary embolism (PE) in most cases. The more proximal the thrombus, the more likely it is to be associated with PE as well as symptomatic deep vein thrombosis (DVT). Patients may survive their PE with little or no pulmonary sequelae only to be disabled by post-thrombotic syndrome (PTS) of the lower extremities. In other cases, patients may experience complications of inferior vena cava filters (IVCF) placed to prevent recurrent symptomatic PE at the time of their index or recurrent PE event. While most IVCFs may be removed with short, uncomplicated procedures, a significant proportion of patients may benefit from invasive procedures to remove retained IVCFs. Whereas most cases of post-thrombotic venous disease may be managed conservatively, iliofemoral recanalization for symptomatic acute iliac vein thrombosis and for post-thrombotic iliac venous obstruction is increasingly performed. Successful recanalization may prevent debilitating symptoms and restore quality of life and occupational productivity. In this chapter, indications, techniques, and outcomes expected with IVCF retrieval as well as recanalization of acute and chronic iliofemoral venous obstruction are discussed as a resource for clinicians managing the care of PE patients.