Post-pulmonary embolism syndrome is defined as exertional dyspnea or exercise intolerance after an acute pulmonary embolism treated with 3 months of anticoagulation. There are several etiologies including for example chronic thromboembolic pulmonary disease. A specialized work-up including echocardiography and pulmonary scintigraphy should be performed. A probability of chronic thromboembolic pulmonary hypertension is extrapolated so that invasive investigations can be performed if necessary. Identification of this pathology is decisive for specific management. Even without pulmonary hypertension, up to 20 % of patients after pulmonary embolism remain symptomatic with exertional dyspnea. Specific management for these patients needs to be defined.