© 2017 The Society of Thoracic Surgeons Surgical pulmonary embolectomy (SPE) is a viable treatment approach for subsets of patients with acute pulmonary embolism. However, outcomes data are limited. We sought to characterize mortality and safety outcomes for this population. Studies reporting inhospital mortality for patients undergoing SPE for acute pulmonary embolism were included. In 56 eligible studies, we found 1,579 patients who underwent 1,590 SPE operations. The pooled inhospital all-cause mortality rate was 26.3% (95% confidence interval: 22.5% to 30.5%). Surgical site complications occurred in 7.0% of operations (95% confidence interval: 4.9% to 9.8%). More investigation is required to define the patient population that would benefit the most from SPE.