Nearly 1 million patients are treated for deep venous thrombosis annually in the United States, typically with anticoagulant therapy alone. While anticoagulation reduces risk for pulmonary embolism, up to two-thirds of patients experience some degree of postthrombotic syndrome. This review details the recent introduction of a variety of novel mechanical thrombectomy devices that, in combination with local delivery of thrombolytic agents, offers a new approach for rapid and effective removal of venous thrombus, while minimizing attendant risks of bleeding complications.