Background Perioperative acute pulmonary embolism would be missed diagnosis and diagnostic errors because of the special state for the patients. Finding out the risk factors , correct and fast diagnosis and appropriate treatment can significantly raise the survival rate and improve prognosis of these patients suffered from perioperative acute pulmonary embolism. 0bjective In order to promptly and accurately diagnose perioperative acute pulmonary embolism and provide a better therapy strategy, we reviewed the articles and the cases in recent years and summarized the risk factors, diagnosis and therapy strategy of perioperative acute pulmonary embolism. Content We reviewed the risk factors, the possible clinical manifestations and test results of perioperative pulmonary embolism. In addition, we also summary the emergent treatments of perioperative acute pulmonary embolism. Trend Emergent precordial Doppler Ultrasoud and transesophageal echocardiography (TEE) may provide a reliably index to diagnose perioperative acute pulmonary embolism. Subcutaneous low molecular weight heparin (LMWH) has a relatively good efficacy in short term anticoagulant therapy of acute pulmonary embolism and emergency embolectomy treatment of perioperative acute pulmonary embolism caused by tumor.