Objectives Right ventricular (RV) dysfunction by echocardiography is a critical finding in risk stratification or treatment of acute pulmonary thromboembolism (PTE). The aim of this study was to investigate the serologic predictors of RV dysfunction before echocardiography in patients with acute PTE. Methods A total of 86 patients with acute PTE were divided into two groups according to the presence of RV dysfunction by echocardiography; the patients with RV dysfunction (group I, n=54, 65.3짹14.2 years, 35 females) versus the patients without RV dysfunction (group II, n=32, 61.0짹16.3 years, 16 females). Various laboratory parameters were analyzed between the groups. Results The levels of N-terminal pro B type natriuretic peptide (NT-proBNP), cardiac specific troponin T (cTnT), and I (cTnI) were significantly elevated, but the level of fibrinogen was significantly decreased in group I than in group II (Table). By receiver operation curve analysis, the area under the curve was 0.917 in NT-proBNP, 0.865 in cTnT, 0.897 in cTnI, and 0.346 in fibrinogen. The optimal cut-off value to predict RV dysfunction by echocardiography was 922.5 pg/mL in NT-proBNP (sensitivity: 94.7%, specificity: 85.7%), 0.014 ng/mL in cTnT (sensitivity: 84.2%, specificity: 92.9%), 0.065 ng/mL in cTnI (sensitivity: 89.5%, specificity: 92.9%). Conclusion NT-proBNP, cTnT, and cTnI are significant serologic predictors of RV dysfunction by echocardiography. Measurements of NT-proBNP, cTnT, and cTnI are simple and useful test in the risk stratification or treatment of acute PTE.