Transvenous pulmonary embolectomy employing a vacuum-cupped directionally controlled catheter is a relatively new technique used in the management of major pulmonary embolism. We present the findings in a patient with acute massive pulmonary embolism who underwent transvenous pulmonary embolectomy, with immediate and marked improvement in hemodynamic function and survival. Insertion of a new intracaval filter at the same time provided protection against recurrent thromboembolism.