Heart failure (HF) is strongly associated with venous thromboembolism (VTE) through mechanisms of hypercoagulability, venous stasis, and endothelial dysfunction. Patients with HF who develop pulmonary embolism present diagnostic challenges due to overlapping symptoms, and they experience higher risks of mortality and bleeding compared with those without HF. Current evidence highlights HF hospitalization as a major transient risk factor for VTE and chronic HF as an intermediate risk factor for recurrence. This article summarizes the pathophysiological links, prognostic implications, and anticoagulation strategies for patients with HF and VTE.