Sudden death from pulmonary thromboembolism following an earthquake has not been reported to date. This is a published case report of a 48-year-old woman who died suddenly of a pulmonary embolism on October 28, 2004. She lived in the Chuetu District in Japan, where a big epicentral earthquake occurred on October 23. She evacuated her house with her family and spent 4 of 5 nights in a private car. Until November 1, 8 persons who had been living out of their cars after evacuation from their houses in the District were treated for pulmonary thromboembolism. The immobility that comes with living in a car should be recognized as a risk factor for venous thromboembolism. In addition, potential preventive measures should be recommended, including provisions for emergency shelters, access to other temporary housing, public education, and the use of compression stockings.