Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 4 2022 04 05 154 6 Mohammad Zarei Department of Orthopedic Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohsen Rostami Department of Neurosurgery, Neuroscience and Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran Furqan Khan Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2021 06 05 2022 04 05 Background: This is a novel observation report on patients undergoing spine surgery with a history of bariatric procedures.   Acknowledgment of aggregated complications in such patients can prevent catastrophic outcomes.   Case Report: We report three patients with spinal disorders and a history of bariatric surgery who developed pulmonary embolism following spine surgery. None of the patients had a history of venous thromboembolism or deep vein thrombosis (DVT) before this event. All patients were given thromboprophylaxis after both bariatric and spine surgery, including intra- and post-operative mechanical and pharmacological thromboprophylaxis upon discharge.   Conclusion: Patients undergoing spine surgery with a history of bariatric procedures are at increased risk of developing venous thromboembolic complications, including pulmonary embolism. We recommend extensive venous thromboembolic evaluation and treating these patients as high-risk individuals even in the absence of active thromboembolic disease.     https://jost.tums.ac.ir/index.php/jost/article/view/286 https://jost.tums.ac.ir/index.php/jost/article/download/286/248