Introduction The purpose of this paper is to present the experience at the Duke University Medical Center with inferior vena caval ligation for thromboembolic disease. A detailed historical review of inferior vena caval ligation is not intended, since a comprehensive review of the subject was recently published by Dale.1 In this discussion, special emphasis is given to (1) the indications for vena caval ligation; (2) venous pressure studies as a guide to the physiologic effect of ligation in the individual patient; (3) phlebography to outline the extent of venous occlusive disease; (4) immediate postoperative complications, and (5) late sequelae and long-term socioeconomic disability. Analysis of Cases Forty patients underwent vena caval ligation for thromboembolic disease; 23 patients were seen at the Duke University Medical Center and 17 patients were treated at the Durham Veterans Administration Hospital. There were 26 male and 14 female patients in the group, and the