Deaths from pulmonary embolism during 1994 among surgical inpatients in three Scottish regions were identified through the Scottish Audit of Surgical Mortality and reviewed to identify the risk factors for thromboembolic disease and the thromboprophylaxis received. Fifty-seven deaths were studied (3 per cent of total deaths); 25 (44 per cent) of the patients had received prophylaxis. Thirty-six patients were in a high-risk group, 19 were at moderate risk and two at low risk. Patients admitted as an emergency, those managed conservatively and those judged to be at moderate risk of thromboembolic disease were most likely not to have received thromboprophylaxis.