The increased risk of venous thrombosis within and below the inferior vena cava (IVC) is the main long-term complication of IVC filter placement. In this article, we discuss current concepts regarding the incidence, risks, and management of IVC filter thrombosis. Evidence of the association of each of the following factors is reviewed: type and design of the filter device, population demographics, underlying hypercoagulable states/anticoagulation, modality used to assess for thrombosis, and length of time elapsed since filter placement. Certain double-basket filter designs and a hypercoagulable state are associated with increased incidence of IVC filter thrombosis. Most cases of IVC filter thrombosis are asymptomatic. While large series data on the use of magnetic resonance imaging for the detection of filter thrombosis remain unavailable, evidence suggests that contrast-enhanced computed tomography is preferable to Doppler sonography. A proposed algorithm for the management of IVC filter thrombosis is provided.