Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in hospitalized patients. Recent guidelines from the Department of Health and the National Institute for Health and Clinical Excellence recommend mandatory, universal VTE risk assessment for hospitalized patients and the provision of appropriate prevention measures (thromboprophylaxis). Careful selection of a suitable VTE risk assessment approach is required to improve the chance of its successful implementation in hospital. At-risk patients need to be identified, counselled and the most appropriate thromboprophylaxis selected, prescribed and delivered. Nurses are ideally placed to play a central role in the implementation of this change in clinical practice through leadership and education. Extended pharmacological thromboprophylaxis has been recommended in certain high-risk groups. New oral anticoagulants are being evaluated, which could change the way thromboprophylaxis is administered in future, benefiting both patients and nurses.