Pulmonary thromboembolism (PTE) is a nosological entity that complicates the course of many diseases. This circumstance determines difficulties in the diagnosis and determination of further patient management tactics. Bolus-enhanced computed tomography of pulmonary arteries, a method having high resolution and high accuracy, is presently accepted to be the gold standard to verify the diagnosis. At the same time this radiocontrast study cannot be used as a screening tool by economic and other reasoning, which determines the importance of the clinical diagnosis of the disease. This review considers different approaches to diagnosing PTE and a base of elaborated clinical algorithms and comparatively assesses empirical and scoring systems for the diagnosis and prediction of a disease course characterized by the rapidness and unpredictability of an outcome even in correctly made diagnosis.