Two clinical cases of the onset and recurrence of pulmonary embolism (PE) in military personnel with penetrating wounds of the lower extremities are presented. Both patients were taking a prophylactic dose of anticoagulants. In the first case, high-risk PE developed with recurrent hypertension and few symptoms, which contributed to late diagnosis and sudden death. In the second case, PE recurred in a patient receiving a full dose of anticoagulants for no apparent reason. Therefore, attention should be paid to this category of patients with penetrating injuries of the lower extremities, their risk of VTE should be stratified in more detail, and the possibility of PE recurrence should be considered, even against the background of anticoagulant therapy.It is promising that risk scales should be reviewed and new criteria for the diagnosis and possibility of recurrence of PE should be developed for this category of patients, which will take into account a greater number of risk factors, develop algorithms for the diagnosis of PE with the possibility of more frequent detailed examinations, and adjust the prophylactic doses of anticoagulants, taking into account the inability to wear elastic stockings due to wounds on the lower extremities.