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The purpose of this study was to determine the risk stratification of deep venous thrombosis (DVT) in patients undergoing gynecological surgery.A retrospective study was conducted with a cohort of 739 consecutive female patients undergoing gynecological surgery between May 2008 and July 2013 in Beijing Chao-yang hospital.DVT of the leg was detected using complete compression and color Doppler ultrasound.Pulmonary embolism (PE) was diagnosed by computed tomography pulmonary angiogram (CTPA).The overall incidence of DVT was 9.20% (68/739) in this patient population, including 16 (2.17%) symptomatic DVT and 52 (7.04%) silent DVT.66(97.06%) DVT events were found within 7 days of surgery and 2 (2.94%) after one week.94.82%thrombi located in distal vein, and the rest 5.18% located in proximal and distal veins.Among the 68 patients with DVT,46patients with suspected PE received CTPA and 21 (45.65%) were confirmed withPE.Six independent factors including varicosevein,bed rest time ≥48h,length of operation ≥3h, laparotomy surgery,hypertension and age ≥50yearswere significantly increased the incidence of postoperative DVT on multivariate analysis.Patients with none or one risk factor are at low risk, with tworisk factors are at moderate risk, with three or more factors are at high risk of DVT.The incidence of postoperative DVT and PEafter gynecological surgery is high in patients withmore than two risk factors.Most patients had no typical symptoms, so noninvasive detection of DVT in 7 days after surgeryis necessary.Appropriate prophylaxis could be performed according to different risk level of DVT.