<b>Background:</b> Pulmonary embolism (PE) is an uncommon and potentially fatal disease in childhood. The clinical presentation is often masked by underlying clinical conditions. <b>Aims and objectives:</b> To determine the prevalence and describe the clinical characteristics of PE in children less than 18 years in a tertiary hospital in Bogota, Colombia. <b>Methods:</b> We retrospectively reviewed electronic medical records from 2006 to 2014 to identify patients with a final diagnosis of PE made by a positive chest CT angiography. <b>Results:</b> During that period, 44.319 patients were admitted in the Department of Pediatrics; 7 patients had a confirmed diagnosis of PE (prevalence of 0.015%); 86% were women, 6-17 years. At clinical presentation 3 had fever and were treated for pneumonia for an abnormal X-ray (42%); hypoxemia, dyspnea, chest pain were documented in 85%, 71% and 57%, respectively; none had hemoptysis. Four patients (71%) had an elevated D-dimer (> 500 mcg/L). All cases had echocardiogram with pulmonary hypertension; only one with right ventricular dysfunction. Six patients had an underlying medical disorder: antiphospholipid syndrome (43%), systemic lupus erythematosus (33%), nephrotic syndrome (28%) and vascular malformation (14%), one had gynecological surgery. All were treated with low molecular weight heparin/warfarin. No fatal cases were reported; one developed chronic thromboembolic pulmonary hypertension. <b>Conclusions:</b> We found that the prevalence of PE in children in our institution is low, as reported in the literature; PE was more frequent in women and adolescents and this may be associated with the high prevalence of autoimmune diseases in that group. As reported, diagnosis was not easy due to the low clinical suspicion.
