Venous thromboembolism (deep venous thrombosis and pulmonary embolism, VTE) is a common complication in surgical patients and is the primary cause of preventable deaths in hospitalized patients. Despite well-known risk factors, VTE prophylaxis is frequently not practiced according to recommended guidelines. Patients can readily be stratified according to their risk of perioperative VTE, and mechanical and pharmacologic prophylactic regimens can be tailored to their individual risk. Pharmacologic VTEprophylaxis should be the standard of care in most clinical settings given its ease of administration, low risk, and cost-effectiveness.