Acute pulmonary thromboembolism (APTE) is a potentially catastrophic event after surgery. We reviewed the literature on surgical pulmonary embolectomy to elucidate its place in emergency management. Although pulmonary embolectomy is invasive, prompt removal of the emboli decreases the right ventricular load and promotes quick recovery of cardiopulmonary function. Conversely, fibrinolytic therapy places additional burden on patients at risk of potential hemorrhagic complication. Surgical embolectomy is an effective procedure with a low risk of hemorrhage because anticoagulant therapy is needed for only a short time.