The objective of the study is to study the pattern, frequency and outcome of vascular events in Omani patients with Behcet's disease (BD). Forty BD patients were recruited. Clinical data parameters were recorded, including age at onset, disease duration, current disease activity, and the vascular manifestations of the disease (current and past events). Disease activity was assessed by ESR, CRP and also clinically. For venous and arterial thrombotic events, imaging studies, such as Doppler ultrasonography, angiography, MRI, CT, and echocardiography were performed. Nine patients had vascular events (23%). The mean age of these patients at diagnosis of the vascular event was 24 years (range 15-37) and the mean disease duration at onset of the vascular event was 3.8 years (range 3-5); this was significant when compared with patients without thrombosis (P=0.001, Mann-Whitney test). In these patients with vascular involvement, two patients (22%) had venous lesions, three (33%) patients had arterial lesions and four patients (44%) had mixed lesions. Two patients (22%) had pulmonary artery aneurysm (PAA) and concomitant intracardiac thrombus, and further one patient also had PAA. Immunosuppressive therapy resulted in the resolution of PAA and intracardiac thrombous. In conclusion, the frequency of vascular complications of BD in our patients is similar to those reported around the world. We found younger male patients with short disease duration are at a greater risk of developing thrombosis. Medical treatment with immunosuppressive therapy without anticoagulation seems successful in treating PAA and intracardiac thrombus.