Pulmonary thromboembolism as a postoperative complication of neurosurgical procedure is seldom reported in Taiwan. Hence we present a patient of parasagittal meningioma who suffered symptomatic pulmonary thromboembolism 10 days after tumor excision operation. Early diagnosis and immediate treatment offered favorable outcome. By this case report, we hope that critical care physicians more alert of this complication and through comprehensive review of the literature, judicious use of perioperative thromboprophylaxis should be emphasized in neurosurgical patients.