Background: Venous thromboembolism (VTE) is the leading cause of morbidity and mortality worldwide among patients undergoing surgical procedures. This study aimed to determine the incidence, predictors, and outcome of VTE among patients undergoing major surgical procedures at Bugando Medical Centre (BMC). Methods: A descriptive longitudinal study involving 381 participants was conducted from February 2020 to July 2020 at BMC. Patients with a high modified Caprini and modified Wells score underwent doppler ultrasound and computed tomography pulmonary angiogram to confirm presence of VTE. Post mortem was performed on participants who succumbed to death prior to these investigations. Categorical variables significance calculated using Chi-square and Fisher’s exact tests. Cox regression analysis was used determine the predictors. Kaplan-Meier survival curve used to depict the occurrence of VTE. Results: The cumulative incidence of VTE was 11.8%. Age ≥45 years, body mass index ≥25, hypertension and prolonged immobilization were significant predictors of VTE. Around 43.0% (n=164) were postoperatively classified as having a high risk of developing VTE. Of these, 27.7% (n=45) developed VTE (p<0.001) of which 14 patients died resulting in a mortality rate of 31.1%, and the mortality was significantly associated with males (p=0.013). Only 17.7% (n=29) of high-risk patients received VTE prophylaxis, however, prophylaxis was protective against development of VTE (p=0.023). Conclusion: Venous thromboembolism is not uncommon among postoperative patients and is associated with high mortality rate. Appropriate VTE screening and prophylaxis is of paramount importance in order to lower VTE morbidity and mortality.