Patients with nephrotic syndrome(NS)have an increased tendency to develop thromboembolism. Pulmonary embolism(PE)is the most common complication causing death in this event. We report a 22-year-old male who presented with NS, and was found to have massive PE. Anticoagulants and steroid were given to improve the clinical symptoms and signs of NS with PE. After treatment for more than 4 weeks, PE had persisted, although the patient's renal conditions improved. Finally, this patient expired abruptly when the anticoagulant was switching from heparin to coumadin.