Pulmonary veins (PVs) are the most proximal source of arterial thromboembolism. Pulmonary vein thrombosis (PVT) is an uncommon clinical condition that can be fatal. Its incidence or prevalence is unclear as existing cases are case reports. It is often seen as a complication of malignancy, lobectomy, atrial fibrillation and less commonly idiopathic. It can be diagnosed using different types of non-invasive imaging studies. We present a 68-year-old woman who was undergoing treatment for recurrent urinary tract infection (UTI) but was incidentally noted to be dyspneic and intermittently hypoxic. She was found to have idiopathic pulmonary vein thrombosis that was successfully managed with systemic anticoagulation.