Patients with pulmonary embolism (PE) can be stratified into two different 
prognostic categories, based on the presence or absence of shock or sustained 
arterial hypotension. Some patients with normotensive PE have a low risk of 
early mortality, defined as <1% at 30 days or during hospital stay. In this 
paper, we will discuss the new prospective for the optimal management of 
low-risk PE: prognostic assessment, early discharge, and single-drug therapy 
with new oral anticoagulants. Several parameters have been proposed and 
investigated to identify low-risk PE: clinical prediction rules, imaging tests, 
and laboratory markers of right ventricular dysfunction or injury. Moreover, 
outpatient management has been suggested for low-risk PE: it may lead to a 
decrease in unnecessary hospitalizations, acquired infections, death, and costs 
and to an improvement in health-related quality of life. Finally, the main 
characteristics of new oral anticoagulant drugs and the most recent published 
data on phase III trials on PE suggest that the single-drug therapy is a 
possible suitable option. Oral administration, predictable anticoagulant 
responses, and few drug-drug interactions of direct thrombin and factor Xa 
inhibitors may further simplify PE home therapy avoiding administration of 
low-molecular-weight heparin.