Venous thromboembolic disease (VTED) is a devastating complication following lower extremity total joint arthroplasty. Various guidelines have been proposed for VTED prevention, the most prevalent being the American Academy of Orthopaedic Surgeons (AAOS) and the American College of Chest Physicians (ACCP). Although there were disagreements in the previous guidelines, there has recently been concordance with the two organizations. Additionally, there are various new pharmacological agents and mechanical devices being utilized and developed for VTED prevention. Therefore, in this review we aim to: (1) evaluate the current ACCP and AAOS guidelines, (2) discuss new chemoprophylactic agents currently available, (3) report briefly on mechanical compression devices to prevent VTED in patients undergoing lower extremity total joint arthroplasty.