Background: Pulmonary embolism (PE) is an obstructive disease of the pulmonary arterial system caused by the embolization of thrombus originating from the deep veins of the lower extremities. Almost 25% patients of PE present with sudden cardiac death and not all patients may have classical symptoms. Hyper-coagulable states have been reported to cause cerebrovascular and myocardial thrombosis but rarely PE. Case Report: We present a case of a 27 year old male who presented to the Emergency Department with complaints of low backache and giddiness. Patient was found to be tachycardic, tachypneic and in shock. Patient had a low probability of PE with a Well’s score of 1.5 but was diagnosed as having massive bilateral acute pulmonary embolism with deep vein thrombosis secondary to protein C deficiency. Conclusions: It is imperative for emergency physicians to have a high index of suspicion in young patients presenting with atypical symptoms and low clinical probability for PE in order to thrombolyse the patient on time.