A 14‑year‑old female patient underwent exploratory laparotomy due to ovarian torsion with necrosis. But she presented acute pulmonary embolism and subjected to emergency thrombolytic therapy followed by maintenance of stable circulation. With stable vital signs, she was transferred to the pediatric intensive care unit, where anti‑infection and anticoagulant therapies were provided. After successful ventilator withdrawal, the patient was discharged, with good recovery during follow‑up visit. It is extremely difficult to diagnose and treat acute pulmonary embolism under anesthesia. Therefore, in addition to preoperative visit, anesthesiologists should closely observe the changes of various detection indicators during the operation, and improve the cognition, diagnosis and treatment of acute pulmonary embolism.