Rapid advances has been made in the diagnosis and treatment of venous thromboembolic disease, but many questions or controversies remain. In this review, we present a progress report on various concepts still open to discussion. New epidemiologic data from the French epidemiology study, Optimev, are presented. Widespread use of multidetector CT scan for the diagnostic work-up of pulmonary embolism has had considerable impact on clinical practices. We discuss indications and use of the various imaging methods. The review ends with a report on constitutional or acquired thrombophilia, particularly cancer-associated venous thromboembolic disease, which remains a daily preoccupation with various approaches still under debate. This review was the topic of the French vascular medicine teaching seminary in November2007.