Pulmonary embolism is a common clinical condition associated with high mortality. Surgical pulmonary embolectomy (SPE), despite having been in existence for over 100 years, is generally regarded as an option of last resort with high mortality rates. Prompt recognition of predictors of mortality, such as right ventricular stress on echocardiography, helps decision-making for immediate surgical pulmonary embolectomy prior to development of significant circulatory collapse, with promising results.<br />We present a 71-year-old male, with recent intracranial bleed and acute massive bilateral pulmonary embolism. The patient underwent successful off-pump surgical pulmonary embolectomy.