Pulmonary embolism is a common clinical condition associated with high mortality.The majority of pulmonary emboli originate from deep venous thrombosis in the popliteal and femoral veins.We present a rare case of a 21-year-old caucasian male patient with massive pulmonary embolism. The source of emboli originated from thrombosed femoropopliteal pseudoaneurysm associated with arteriovenous fistula which was caused by a bullet injury 7 years before. The patient underwent successful surgical pulmonary embolectomy followed by aneurysmectomy with reconstruction of femoral and popliteal vessels.