A 61-year-old white male with recurrent thrombophlebitis developed a painful left arm. He was initially diagnosed with superficial thrombophlebitis and treated conservatively for several days without improvement. He subsequently developed right-sided pulmonary embolism. Hypercoagulability was not present, and venography confirmed the left basilic vein as the sole thrombogenic source. Twelve to twenty percent of documented pulmonary emboli arise from deep veins of the upper extremity. To our knowledge, only one case of basilic vein thrombosis causing pulmonary embolism exists in the literature. Clinical vigilance to this uncommon entity may reduce attendant morbidity and mortality.