Abstract: This article reports the perioperative anticoagulation management of a patient with multiple traumatic fractures and renal contusion who developed new-onset venous thromboembolism(VTE). It explores the comprehensive perioperative anticoagulation management for patients at high risk of VTE following acute massive hemorrhage post-trauma. Taking anticoagulation as the entry point, closely monitored patients' symptoms of thrombosis and bleeding as well as their coagulation function indicators, promptly formulating and optimizing anticoagulation treatment plans ranging from VTE prophylaxis to post-VTE formation, thereby controlling the progression of thrombosis while minimizing the risk of exacerbated bleeding. No uncontrollable bleeding events occurred during the patients' treatment. This article analyzes the risk factors for perioperative VTE in high-risk patients who experience acute massive hemorrhage post-trauma and are complicated by VTE, providing references for anticoagulation treatment protocols in the prevention and management of VTE in trauma patients.