Over the last 15 years, diagnostic strategies to diagnose deep vein thrombosis (DVT) and pulmonary embolism (PE) have changed significantly. The gold standard for detecting DVT is still venography, but invasivity, radiation, contrast media, and the painful injection in pedal veins are limiting factors for initial and repeat examinations. The introduction of DVT scores, D-dimer testing, and venous ultrasound has made venography replaceable in most cases. This review focuses on different diagnostic strategies for clinicians in hospitals as well as for general practitioners using practical approaches.