The symptoms and signs of acute pulmonary arteries thrombosis are nonspecific. So clinical suspicion is the most important in the diagnosis. Treatment of pulmonary thromboembolism include anticoagulant, thrombolytic agent, or surgical intervention. We experienced a case of recurrent pulmonary thromboembolism without coagulation defect and any risk factor except old age and obese. Initially we treated with heparin, but clinical symptoms were aggravated. After we changed to urokinase (total 330 million IU/2 days), the pulmonary arteries obstruction were resolved and clinical symptoms were improved without any complications. So we report this clinical experience with review of articles.