This is a review of the literature on diagnosis and treatment of pulmonary embolism published in the Canadian Journal of Rural Medicine in 2005 and updated after the PIOPED II results came out. It is slanted in recommendations toward isolated and rural practices. The original diagnostic flowsheet does not project well on the small screen, so a text diagnosic algorithm is substituted for quick reference. The article is written as a checklist, beginning with the need to think of the diagnosis.