OBJECTIVE： To observe clinical efficacy and safety of rivaroxaban in the treatment of pulmonary embolism. METHODS： 100 patients with pulmonary embolism were selected and randomly divided into observation group and control group， with 50 cases in each group. Both groups were given nursing intervention for rehabilitation. Observation group was treated with rivaroxaban 15 mg， bid， for consecutive 3 weeks， 3 weeks later adjusting to 20 mg， qd； control group was given low molecular weight heparin 1 mg/kg， bid， combined with warfarin sodium 5 mg， qd， for more than 5 days， stopped taking low molecular weight heparin until the INR reached the target 2-3 and given warfarin alone orally. Treatment course of 2 groups lasted for 3 months. Clinical efficacy of 2 groups were observed， and PaO2， PaCO2 and D-dimer levels were observed in 2 groups before and after treatment； the improvement of clinical symptoms as cough， pectoralgia， dyspnea， and the incidence of ADR were recorded in 2 groups. RESULTS： The total effective rate of observation group （90.0％） was significantly higher than that of control group （74.0％）， with statistical significance （P＜0.05）. After treatment， PaO2， PaCO2 and D-dimer levels of 2 groups were increased significantly， compared with before treatment； the observation group was higher than the control group， with statistical significance （P＜0.05）. The remission rate of clinical symptoms as cough， pectoralgia， dyspnea in observation group was significantly higher than in control group， with statistical significance （P＜0.05）. The incidence of ADR in observation group （12.0％） was significantly lower than in control group （30.0％）， with statistical significance （P＜0.05）. CONCLUSIONS： Rivaroxaban supplemented by reasonable nursing intervention can effectively improve clinical efficacy of patients with pulmonary embolism with low incidence of ADR.