When summoned to evaluate a patient with newly diagnosed acute pulmonary embolism (PE), accurate risk stratification and prognostication will facilitate appropriate triage to an ICU, telemetry unit or, under special circumstances, to outpatient management. At one extreme, no special triage skills are necessary for the PE patient with hypotension and in cardiogenic shock. Such a patient will be readily directed to an ICU for thrombolysis, interventional laboratory for catheter embolectomy, or operating room for surgical embolectomy. At the other extreme, some PE patients have such a small thrombus burden and are in such excellent physical shape that they can be managed as if they had an uncomplicated acute proximal leg deep vein thrombosis. However, few cases are this clear cut.