OBJECTIVE： To explore the role of clinical pharmacists participating in the therapy for patients with acute pulmonary embolism （APE） complicated with hepatic insufficiency. METHODS： Clinical pharmacists participated in the therapy for a APE patient with hepatic insufficiency. According to patient’s condition， clinical pharmacists assisted physicians to formulate preliminary therapy plan， but INR was not up to the standard after given warfarin 2.5 mg/d empirically； clinical pharmacists calculated the dose of warfarin using Gage algorithm and IWPC algorithm. It was suggested to give initial dose of warfarin 7 mg/d for 2 days and maintenance dose of warfarin 5 mg/d， and the patient received medication education. RESULTS： Physicians adopted the suggestion of clinical pharmacists to shorten the time of reaching INR standard significantly and improve the compliance of patients with warfarin. CONCLUSIONS： Clinical pharmacists participate in the formulation of warfarin individualized dose and medication education to ensure the safety and effectiveness of drug use.