Pulmonary thromboembolism (PTE) results from clot formation and subsequent embolism into the pulmonary vascular bed. This causes a decrease in blood flow to the affected area of lung and may also result in pulmonary hypertension. Definitive diagnosis requires invasive imaging studies or scintigraphy. Patients with pulmonary thromboembolism are generally not good anesthetic candidates and nuclear imaging is not widely available, making ante-mortem diagnosis of PTE difficult. Presumptive diagnosis can be made using radiographs, changes seen on blood work, and echocardiography. Predisposing conditions include anything that causes vascular stasis, endothelial damage, or a hypercoagulable state. This case discussion follows a patient that was presumptively diagnosed with PTE following multiple abdominal surgeries and subsequent complications including septic peritonitis with multi drug resistant and fungal organisms, bile duct obstruction, and disseminated intravascular coagulation (DIC).