Background and Aims Inferior vena cava (IVC) thrombosis is often secondary to IVC filter implantation. The acute phase mainly manifests as limb swelling and pulmonary embolism (PE), and the chronic phase manifests as IVC stenosis, occlusion and post-thrombotic syndrome. Early removal of acute IVC thrombosis is clinically recommended to reduce complications. AngioJet has been widely used for removing acute lower extremity deep venous thrombosis, but there are few studies on the method and effect of acute IVC thrombus removal. Therefore, this study was conducted to investigate the efficacy and safety of the AngioJet thrombectomy device in the treatment of acute IVC thrombosis.Methods The clinical data of 58 patients with acute IVC thrombosis undergoing AngioJet treatment in the Department of Vascular Surgery of Beijing Jishuitan Hospital from July 2020 to June 2021 were retrospectively analyzed. The surgical safety, incidence of PE, efficacy of thrombus removal and rate of filter removal as well as the increase in postoperative hospital stay and cost for thrombus treatment were evaluated.Results All the 58 patients had retrievable filters implantation, of whom, the filters were successfully removed in 56 cases (96.6%), and 2 cases (3.4%) were lost to follow-up 3 months later without filter removal. After AngioJet treatment, 10 cases (17.2%) had grade III thrombus clearance, 34 cases (58.6%) had grade II clearance, and 14 cases (24.1%) had grade I clearance; after combination of catheter aspiration or catheter-directed thrombolysis (CDT), 14 cases (24.1%) had grade III clearance, 36 cases (62.1%) had grade II clearance, and 8 cases (13.8%) had grade I clearance. During the three-month follow-up, 2 cases (3.4%) developed IVC occlusion, and the venous patency rate was 96.6%. There were 16 patients (27.6%) with PE before operation, PE symptoms occurred or the PE symptoms became exacerbated in 2 cases (3.4%) after operation, and remained unchanged or were relieved in the other cases. The difference in symptoms of PE showed no statistical significance before and after operation (P>0.05). The liver and renal function parameters of the patients were increased after operation, but all of them did not reach the diagnostic criteria for acute liver injury and kidney injury. A total of 22 patients (37.9%) were treated with AngioJet alone, their postoperative hospital stay was increased by (1.45±0.51) d, and medical cost was increased by (27 248±78) yuan; a total of 36 patients were treated with AngioJet combined with catheter thrombectomy and (or) CDT, their postoperative hospital stay increased by (2.22±1.22) d, and the increase in medical expenses was (30 607±1 134) yuan, and the difference had statistical significance (both P<0.05).Conclusion AngioJet thrombectomy is safe and effective for removal of acute IVC thrombus without increasing the risk of symptomatic PE. The combined use of catheter thrombectomy and CDT can increase the thrombus removal effect, but it will prolong the postoperative hospital stay and increase the related medical expenses.