OBJECTIVES: To determine the cost effectiveness of using a diagnostic strategy in the diagnosis of Venous Thromboembolism (VTE).  METHODS: We retrospectively reviewed the data from a D-dimer clinical study (FDA 510(k) Number: k133582) that utilized the VTE diagnostic strategy. Instead of using imaging based diagnosis on all suspected VTE patients, the diagnostic strategy recommends screening of suspected patients using the pretest probability scores and classifying patients as “high”, “moderate” and “low” risk. “High” risk patients are sent straight to imaging, whereas the “moderate” and “low” risk patients are subjected to a D-dimer blood test. Patients with D-dimer levels above the cut-off value (500 ng/mL Fibrinogen Equivalent Units (FEU)) are sent to imaging, but those with levels below the cut-off value can be safely excluded of VTE. The D-dimer test under consideration, in combination with pretest probability has reported a Negative Predictive Value and Sensitivity of 100%. Using the proportion of excluded VTE suspected patients from the study and cost per test from Centers for Medicare and Medicaid Services (CMS), we developed a simple economic model. The model allowed us to determine the change in the average VTE diagnostic test cost per patient, both before and after the implementation of the VTE diagnostic strategy.  RESULTS: Implementation of the VTE diagnostic strategy reduced the average diagnostic test cost for pulmonary embolism (PE) by 38% and for Deep Vein Thrombosis‎ (DVT) by 25%. Assuming a division of VTE as 30% PE and 70% DVT, the weighted average reduction in the diagnostic test cost per VTE patient was 32%. CONCLUSIONS: The VTE diagnostic strategy has existed for over a decade but its utilization is still reported to be low. This analysis will provide decision makers an incentive to implement the VTE diagnostic strategy. It is beneficial as it will allow hospitals to cut costs without compromising patient safety.