Background: There is a growing body of evidence against the use of triple therapy (anticoagulation and dual antiplatelet) among patients with acute coronary syndrome. Venous thromboembolism (VTE) is another potential indication for triple therapy, but the magnitude of such problem is unknown. Therefore, we aimed to determine the trends of annual rate of immediate VTE occurrence in patients with ST-segment elevation myocardial infarction (STEMI) and measure its impact. Methods: We queried the 2003-2013 Nationwide Inpatient Sample to identify adults with primary diagnosis of STEMI using ICD-9-CM codes. VTE, including limb vein thrombosis and pulmonary embolism, was allocated when present among the secondary discharge diagnosis. Demographics and inpatient outcomes were compared in the VTE and non-VTE group. Results: From 2,495,757 hospitalizations for STEMI, 15,471 (0.6%) also experienced VTE. The group who experienced VTE was older (mean age: 68.44 vs 64.81, p<0.01) and had higher proportions of black patients (10.6% vs 7.7%, p<0.001) and females (42.1% vs 35%, p<0.001) compared to the non-VTE group. There was an increasing trend in the annual rate of VTE during the study period (2003: 0.3% vs 2013: 0.9%, p < 0.01). Patients with VTE had a prolonged hospitalization (12.8 vs 4.63 days, p <0.01), higher risk of gastrointestinal bleeding (OR:1.65; 95% CI 1.54-1.76, p<0.01) and intracranial hemorrhage(OR:1.52, 95% CI:1.23-1.87, P<0.01), needed more blood transfusions (OR:1.74; 95% CI:1.66-1.82, p<0.01) and had increased mortality (OR:1.53, 95%CI:1.46-1.6, p<0.01). Conclusion: There is an increasing annual rate in immediate VTE occurrence in patients with STEMI. VTE is associated with more bleeding complications, longer hospital stay, and higher mortality. It is plausible that individualized or more aggressive protocols of VTE prophylaxis are needed in this population.