To assess utilization of prophylactic inferior vena cava filter (IVCF) placement and associated outcomes of pulmonary embolism (PE), deep venous thrombosis (DVT), and overall mortality in severely injured trauma patients at high thromboembolic event risk. Using the National Trauma Data Bank (NTDB) from 2008 to 2015, adult patients with severe orthopedic, spinal cord, or intracranial injuries (Injury Severity Score [ISS] ≥15) admitted to level I-IV trauma centers were identified. IVCF filters placed within 48 hours of admission and before any lower extremity venous ultrasound examinations were deemed prophylactic. Predictors of prophylactic IVCF receipt were determined using logistic regression. Associations between prophylactic IVCF placement, PE, DVT, and in-hospital mortality were also estimated with separate logistic regression models adjusting for year of injury, injury type, age, sex, ISS, race, and geographic region. Of 549,593 unique trauma admissions meeting inclusion criteria, 5,537 (1.0%) underwent prophylactic IVCF placement. Utilization decreased over time (OR: 0.80, P < 0.01). Predictors of prophylactic IVCF receipt were combined intracranial, orthopedic, and spinal cord injuries (OR: 5.01, P < 0.01), northeast region (OR: 2.50, P< 0.01), and increasing ISS score (OR: 1.04 per 1 unit increase, P < 0.01). Overall PE prevalence increased minimally (0.98% in 2008 to 1.08% in 2015). Prophylactic IVCF placement was associated with increased occurrence of PE (OR: 1.48, P < 0.01) and DVT (OR: 2.36, P < 0.01), but decreased overall mortality compared to similar non-IVCF cohorts (OR: 0.69, P < 0.01). In patients undergoing prophylactic IVCF with isolated intracranial, orthopedic, and spinal injuries, estimated probabilities of death decreased 29.1%, 30.5%, and 30.7%, respectively. Prophylactic IVCF placement in severely injured trauma patients at high thromboembolic event risk was associated with decreased overall mortality, but increased rates of PE and DVT. Prospective evaluation of prophylactic IVCF placement in severely injured trauma patients is warranted.