Objective To summarize the clinical characteristics of postoperative acute pulmonary embolism (PE) in otolaryngology patients and analyze the the experience of diagnosis and treatment. Methods Clinical data of otolaryngology patients who developed PE within 1 month after surgery from January 2015 to December 2022 were retrospectively analyzed. Results The incidence of PE was 0.05% (12/25 368) within 1 month after surgery in otolaryngology department. The primary clinical symptoms included dyspnea 33.3%(4/12), palpitation 16.7%(2/12), syncope 16.7%(1/12), and asymptomatic 41.7%(5/12). Among the 12 patients, blood oxygen saturation/arterial blood oxygen partial pressure decreased in 7, and filling defects of pulmonary artery or their branches were confirmed by CT pulmonary angiography in 11. Two patients with high-risk and two with low-risk were transferred to intensive care unit. Anticoagulation treatment was effective in 11 patients, and 1 patient died after rescue. Anticoagulation was discontinued in 3 cases due to active bleeding. Conclusions The clinical symptoms of PE are not typical, and attention should be paid to postoperative manifestations such as dyspnea, palpitation, syncope, and decrease of blood oxygen saturation. Early recognition, accurate judgment of severity and prompt standardized treatment are the key points to improve prognosis. High-risk patients with unstable hemodynamics have a poor prognosis and need to be transferred to intensive care with early initiation of anticoagulation or thrombolytic therapy.