Background: Patients with Cushing’s syndrome have an increased risk of thrombosis due to acquired hypercoagulability. Case Presentation: A 54-year-old obese female, with underlying iatrogenic Cushing’s syndrome (ICS), presented with a sudden onset of dyspnea and circulatory collapse. Computed tomography pulmonary angiogram confirmed acute massive pulmonary embolism (PE). She showed marked improvement after treatment with anticoagulation. Conclusion: This case demonstrates the clinical presentations and pathophysiology of Cushing’s syndrome (CS). CS patients are prone to thrombosis due to disturbance in all three components of Virchow’s triad. PE is one of the leading causes of mortality in CS. Clinicians should be aware of this serious, but less recognized, complication when a patient with CS presents with acute circulatory collapse. Anticoagulants remain the mainstay of treatment in ICS complicated by PE.

Keywords: Cushing’s syndrome, corticosteroids, thrombosis, pulmonary embolism, anticoagulation, case report