Nephrotic syndrome (NS); the first described in 1827 as the presence of proteinuria of ≥ 3.5 g/24 hours, albuminemia < 3.0 g, peripheral edema, hyperlipidemia, lipiduria, and increased thrombotic risk which has an incidence of three new cases per 100 000 each year in adults. Nephrotic syndrome had complicated by the induction of a hypercoagulable state with both various venous and arterial thromboembolic events. The pathophysiology of hypercoagulability in the nephrotic syndrome is imbalances of prothrombotic and antithrombotic factors, as well as impaired thrombolytic activity occurs. Here we present, a 19 years old female came to the emergency department with a complaint of chest pain and shortness of breath for three days. The patient quickly diagnosed pulmonary embolism and inferior vena cava thrombosis as a complication of nephrotic syndrome, allowing prompt initiation of anticoagulant therapy. After two weeks of admission, the patient's resolved dramatically, and his laboratory results returned to almost normal, and the patient discharged with Oral Prednisolone, Coumadin, Atorvastatin, and Ramipril. We aim to determine which is the likely cause of pulmonary embolism in patients with the nephrotic syndrome.