Backgroud and Objectives The aims of this study was to investigate the variables of computed tomographic angiography (CTA) findings relevant to treatment modalities in patients with acute pulmonary thromboembolism (PTE). Methods A total of 82 patients with acute PTE were divided into two groups according to treatment modalities; thrombolysis group (group I, n=50, 64.1짹14.6 years, 31 females) versus anti-coagulation group (group II, n=32, 63.9짹15.5 years, 20 females). Various CTA findings of acute PTE were analyzed between the groups. Results CT index of pulmonary arterial clot load was significantly higher in group I than in group II (19.7짹3.4 vs 13.6짹6.4, P<0.001). The dimension of right ventricle (RVD) was significantly larger (46.7짹6.5 vs 42.8짹7.5 mm, p=0.016) and the dimension of left ventricle (LVD) was significantly smaller in group I than in group II (33.1짹6.9 vs 39.5짹8.6 mm, p<0.001). The ratio of RVD/LVD was significantly higher in group I than in group II (1.49짹0.40 vs 1.13짹0.35, p<0.001). Contrast regurgitation to inferior vena cava (IVC) was significantly prevalent in group I than in group II (90.0 vs 53.2%, p<0.001). However, the dimensions of superior vena cava, azygous vein, and main pulmonary artery, septal bowing to LV, and the presence of pulmonary infarction or pleural effusion were not different between the groups. By receiver operation curve analysis, the area under the curve was 0.812 in CT index of clot load, 0.774 in the ratio of RVD/LVD, 0.658 in RVD, and 0.294 in LAD. The cut-off value to predict thrombolytic treatment was 19.5 in CT index of clot load (sensitivity: 82.0%, specificity: 83.3%), 1.25 in the ratio of RVD/LVD (sensitivity: 74.0%, specificity: 73.3%), and 43.5 mm in RVD (sensitivity: 70.0%, specificity: 63.3%). Conclusion The results of this study suggested that CT index of clot load, the ratio of RVD/LVD, RVD, and contrast regurgitation to IVC were significant CTA variables relevant to thrombolytic therapy in patients with acute PTE.