Pulmonary embolism (PE) is a common disorder that is accompanied by signifi
cant morbidity and mortality. Although anticoagulation is the standard trea
tment for PE, thrombolytic therapy, with its ability to produce rapid clot
lysis, has long been considered an attractive alternative. Although many st
udies have been pel formed over the past three decades, however, the indica
tions for the use of thrombolytic agents in patients with PE remain controv
ersial. In this article, we review the medical literature and provide evide
nce-based guidelines for the use of thrombolytic therapy. We will also disc
uss the practical aspects of PE thrombolysis.