Although the correct prophylaxis of deep venous thromboembolism in hospitalized patients is of utmost importance, and over time several authoritative guidelines have been developed, the overall degree of their implementation remains low. A major obstacle to this goal is that guidelines do not represent real patients, since their indications come from clinical trials whose population is quite different from that of clinical daily practice. Starting from the most recent literature, we suggest a risk assessment model tailored for operational realities in Italy aimed to provide an useful tool for improving the practice of venous thrombosis prophylaxis.