Background: Venous thromboembolism (VTE) is a major problem in all hospitalized patients, which can be prevented by following practice guidelines. Appropriate identification and management of patients at risk is critical in order to maintain patient safety. Aim: To determine the risk of VTE and the use of anticoagulant prophylaxis according to Caprini score for hospitalized patients at King Abdulaziz University Hospital (KAUH). Methodology: We conducted a cross-sectional study at KAUH from July to August 2017. All inpatients from medical ward (aged ≥ 40 years), surgical ward (aged ≥18 years), and obstetrics and gynecology (OB/GYN) ward were included. Patients receiving anticoagulant treatment were excluded. We used the Caprini scoring system to assess the risk of VTE and recommended regimen. Results: A total of 496 inpatients were included in the study. Of those patients, 33.3% were surgical, 31% were medical, and 35.7% were OB/GYN patients. The mean participant age was 48.62 years. The percentages of patients within the risk categories (low, moderate, high, and highest) were 7.5%, 9.7%, 25.2%, and 57.7%, respectively. Among our sample, 248 (50%) patients received VTE prophylaxis. However, 213 (42.9%) received appropriate pharmacological doses. Of the 248 (50%) patients who did not receive any prophylaxis, 5.8% were in the low-risk group, 10.1% had contraindications, while the majority (34.1%) had no obvious reason. Conclusion: The majority of the patients who were eligible for prophylaxis were managed properly. But still, there is underuse of prophylaxis in the sample as whole. Also, the implementation of mechanical prophylaxis is needed in our hospital.