Purpose To identify the incidence of hospital-acquired venous thromboembolism (HAVTE), evaluate the VTE risk factor screening, and evaluate the use and effectiveness of prophylactic agents used in HAVTE patients at St Vincent's Medical Center (SVMC). Methods The SVMC's database was queried from January 2005 to December 2006 for all the discharges with a secondary diagnosis of deep vein thrombosis (DVT) and/or pulmonary embolism (PE) and patients with a primary diagnosis of DVT and/or PE who were readmitted within 30 days of their previous admission from SVMC. Results A total of 421 charts were screened and 91 charts, representing patients with HAVTE, were included. Among these patients, 56% of subjects suffered from a DVT, 31% had a PE, and 13% had both a DVT and PE. Thirty-five percent of the patients' prophylactic therapy was noncompliant with the American College of Chest Physician's (ACCP) 2004 VTE prophylaxis guideline recommendations. Documentation of patient risk factors was present in 8.8% of all the patients with HAVTE. Twenty-one percent of the patients were not prescribed any VTE prophylactic agent, of which 89% qualified for VTE prophylaxis. Conclusions The incidence of HAVTE was found to be 2.24 cases per 1000 discharges from SVMC. The prophylactic therapy among the patients with HAVTE was compliant with the ACCP's VTE guideline recommendations in 65% of cases. The documentation of risk factor screening was found to be 8.8%. The current DVT/PE protocol at SVMC needs revision to provide a more consistent assessment of patient risk factor, and implementation of DVT/PE prophylaxis throughout the continuum of care based on the current guidelines.