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Subsegmental pulmonary embolism (SSPE) is a controversial entity as they have uncertain clinical significance. As a result, the Chest and ACEP guidelines state that a very select group of patients with isolated SSPE and no deep vein thrombosis may be managed with surveillance rather than anticoagulation. In this podcast, we review SSPE and a new prospective study by Le Gal and colleagues evaluating outcomes after withholding anticoagulation in patients with subsegmental pulmonary embolism (SSPE).