Venous thromboembolism is one of the most common complications of cancer, which also contributes to mortality in cancer patients. Venous thromboembolism can be observed as the first manifestation of occult cancer. We present the case of a 54-year-old woman with deep vein thromboembolism and pulmonary embolism as the first signs of cancer, who was subsequently diagnosed with disseminated adenocarcinoma, most likely originated from the pancreatico-biliary system.