Various neurologic and vascular injuries complicating the technique of tourniquet ischemia for limb surgery are well known. We found no reports of the serious complication of massive pulmonary embolism as a consequence of this technique. This is surprising when one considers the type of patients surgeons deal with in the use of the technique of tourniquet ischemia. These patients are traumatized and immobile, with high potential for development of deep venous thromboembolic disease, and are subjected to extensive extremity manipulation. Such patients are ideal candidates for the development of massive pulmonary embolism. We have encountered and successfully treated a patient with such a complication.