Venous thromboembolism (VTE) represents a major source of morbidity and mortality in patients undergoing surgery. Effective prophylaxis is crucial due to high rates of postoperative VTE and substantial associated healthcare costs. Understanding the pathophysiology and identifying individual risk factors through validated scoring systems help tailor prophylactic strategies. Pharmacological agents such as LMWH, UFH, DOACs, and aspirin, along with mechanical methods and other adjunctive measures may significantly reduce the incidence of VTE. Ultimately, anesthesiologists play a critical role in helping develop and apply evidence-based prophylactic regimens.