Pulmonary embolism is a life threatening disease that needs early and accurate diagnosis and prompt management. We have experienced a case of hepatocellular carinoma with pulmonary embolism and subsequent puhnonary infarction. The abdominal CT showed multiple geographic low-density masses in the liver. The masses were extended to the inferior vena cava. The amount of alpha-fetoprotein was 1,150 ng/ml. The chest CT revealed almost complete obstruction of left main pulmonary artery and right inferior lobar artery by emboli and subsequent pulmonary infarction. The evidence of deep vein thrombosis and any other risk factor of pulmonary embolism was not found. He died of sudden cardiac arrest on the 12th day after admission. (Kor J Gastroenterol 1998;32:402 - 406)