Venous thromboembolism (VTE) is an increasing public health concern, in part because of lack of awareness among patients and physicians. Nonpenetrating trauma to the legs may be an under-recognized potential risk factor for VTE. We report a case of VTE following vigorous deep tissue massage in a previously healthy 67-year-old man with no other identifiable risk factors. The etiology, risk factors, and implications for the prevention and detection of VTE are reviewed. There are few other published reports of VTE associated with massage, but under-reporting seems likely. Vigorous massage or any equivalent trauma to the legs should be considered and evaluated as a possible risk factor for VTE, especially in older adults. Additional research is needed to clarify the risks associated with nonpenetrating trauma to the legs in older adults and other susceptible groups. Improved awareness of VTE, including its risk factors and symptoms, is an urgent priority for more effective prevention, detection, and treatment.