Background: Venous thromboembolism (VTE) remains one of the most important causes of mortality and morbidity in the hospitalized patient. This is particularly evident in patients with cancer who are exposed to a four- to sixfold increased risk of VTE compared with those patients without cancer. Methods: A review of the current literature was undertaken on prophylaxis and management of VTE in patients with cancer. Results: Primary VTE prophylaxis is recognized to be the single most effective strategy that improves patient safety. Many clinical trials have demonstrated the benefit of primary prophylaxis for patients with cancer and evidence-based, best practice guidelines for specific subgroups of patients with cancer are well accepted by most clinicians. Despite this, many patients at high risk for VTE either receive no VTE prophylaxis or are exposed to VTE complications due to sub-optimal prophylaxis. Implementation of best practice guidelines still falls far short of clinical acceptable levels for VTE prophylaxis and management. Conclusion: VTE prevention in patients with cancer results in reduced morbidity and mortality, outcomes that are unquestionably attainable. This review of the current evidence supporting VTE prophylaxis in patients with cancer will hopefully act as a stimulus to provide patients with cancer access to the best, evidence-based, thromboprophylactic management available.