From 1987-2019 maternal mortality rose across the United States from 7.2 deaths per 100,000 births to 17.6 deaths per 100,000 births [1]. Between 2017 and 2019 venous thromboembolism (VTE) accounted for 10.5% of all maternal deaths in the USA [1]. Pregnancy is a hypercoagulable state; coagulation factors, von Willebrand factor, and fibrin are significantly increased and do so progressively with each trimester 2, 3, 4. Decreased venous flow velocity, venous distension, and disruption of venous return by the growing gravid uterus result in stasis of blood flow [5]. Finally, labor and delivery-specific factors may cause vascular trauma. The risk of pregnancy associated VTE increases throughout pregnancy and peaks in the post-partum period. Given the potential for cardiovascular decompensation or collapse associated with high risk PA-PE in particular, and the complexities around risk-stratification, this review aims to provide an overview of the diagnosis, risk stratification and management options for PA-PE via summation of previously published literature and expert opinion. Additionally, the authors will emphasize areas where there is an ongoing paucity of data and will suggest areas for future research.