The thesis covers the clinical approach of venous thromboembolism (VTE) in pregnancy. Pregnancy is a risk factor for VTE and accountable for up to 30% of VTE in women younger than 45 years. During pregnancy, risk of VTE is increased due to prothrombotic hemostatic changes, stasis of blood flow as a result of pressure of the gravid uterus and vessel wall damage during delivery. In absolute terms, one to two in 1,000 pregnancies is complicated by VTE. Women with a personal history of VTE especially are at high risk of recurrent thrombosis during a subsequent pregnancy. In the first part of the thesis we focus on the prevention of VTE in pregnancy and the postpartum period. We describe the results of the Highlow study. In this large open-label, multicenter, randomized, controlled trial we compared a weight-adjusted intermediate-dose low-molecular-weight heparin (LMWH) to a fixed low-dose LMWH for the prevention of a pregnancy-related recurrence. Other subjects discussed in this part included the safety of inferior vena cava filters in pregnant patients and the exposure of direct oral anticoagulants in pregnancy. In the second part of the thesis, we describe the diagnostic management of pulmonary embolism and deep-vein thrombosis (DVT) during pregnancy in the Artemis study. In this prospective management study, the pregnancy-adapted YEARS algorithm enables physicians to safely rule-out pulmonary embolism without CT-scanning in 40% of pregnant patients in whom this diagnosis is suspected. In the third part of the thesis we address the long-term outcomes of VTE such as post-thrombotic syndrome and quality of life after VTE.