Pulmonary embolism is a major, but potentially preventable, cause of maternal mortality in North America and Europe. Because venous thromboembolism is an infrequent cause of maternal morbidity, there are few randomized clinical trials to guide clinical decision-making with respect to treatment, prevention, and evaluation of innovative management modalities such as low molecular weight heparin. This article focuses on the evidence supporting the current guidelines for the pharmacologic management of venous thromboembolic disease in pregnancy.