Introduction Venous thromboembolism is an important complication of surgery that results in high morbidity and mortality. Screening of at risk patients and institution of adequate thromboprophylaxis has been shown to reduce the case fatality rate. Materials and Methods The retrospective arm of the study was aimed at determining the risk distribution among surgical patients from the departments of General Surgery, Orthopaedics, Obstetrics and Gynaecology over a twelve month period in Obafemi Awolowo University Teaching Hospital Complex, Ile-ife, and to evaluate the pattern of usage of prophylactic anticoagulant in these patients. The prospective arm of the study was aimed at assessing the total risk score of VTE among surgical patients before a major operation using three tools (Venous thromboembolism Risk Factor Assessment by Caprini et al, Revised Geneval Score for pulmonary embolism and Pretest probability of Deep Venous Thrombosis by Wells). It also aimed to determine the relationship between the risk score and full blood count (FBC),activated partial thromboplastin time (aPTT), prothrombin 2 time/international normalised ratio (PT/INR), fibrinogen and D-dimer assays , before and 48hours after surgery.