Venous air embolism is an infrequent, but potentially disastrous, occurrence after the insertion or removal of central venous catheters. The authors describe fatal venous air embolism after removal of a central venous catheter in a 43-year-old man recovering from coronary artery bypass surgery. They discuss the pathophysiology, diagnosis, treatment, and prevention. Several practical considerations are necessary to prevent this complication of central venous catheterization, a procedure commonly delegated to junior house officers.