Fig. 1— Nonthrombotic pulmonary embolism (NTPE) is characterised as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. NTPE presents a diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations, such as acute respiratory distress syndrome (ARDS) after fat and amniotic embolism, to signs observed late in the disease course, such as after tumour emboli. Moreover, paradoxical nonthrombotic emboli may cause cerebral signs and symptoms.