Coil embolization is an effective and safe treatment of pelvic congestion syndrome. Cases of coil pulmonary migration have been reported after pelvic embolization. However, most cases are usually asymptomatic and do not require specific treatment. We present the first case of pulmonary coil migration after pelvic embolization and concomitant acute pulmonary embolism in a symptomatic patient. The patient was treated with standard anticoagulation and conservative measures without incidences after hospital discharge.