Study　Design.　A　case　report　and　literature　review.　Objective.　To　present　a　case　of　dynamic　detection　of　a　large　pulmonary　cement　embolus　as　it　formed　and　migrated　during　percutaneous　vertebroplasty,　which　was　successfully　managed　by　percutaneous　endovascular　retrieval.　Summary　of　Background　Data.　Pulmonary　embolism　resulting　from　cement　leakage　after　percutaneous　vertebroplasty　to　treat　osteoporotic　vertebral　compression　fracture　has　been　described　rarely;　however,　the　frequency　of　this　complication　may　increase　secondary　to　the　expanding　use　of　percutaneous　vertebral　augmentation　techniques.　Methods.　The　formation　of　a　large　embolus　of　acrylic　cement　and　its　migration　into　the　pulmonary　artery　was　observed　in　real　time　in　a　55-year-old　female　with　osteoporotic　vertebral　compression　fracture　of　L4　during　percutaneous　vertebroplasty.　Results.　Pulmonary　arteriography　confirmed　the　presence　of　the　cement　embolism　in　the　right　pulmonary　artery　during　the　operation.　Percutaneous　endovascular　retrieval　of　the　cement　fragments　was　performed　successfully　via　an　interventional　catheter　procedure　and　subsequent　incision　of　the　femoral　vein.　The　patient　made　an　uneventful　recovery.　Conclusion.　As　illustrated　by　our　case,　large　cement　emboli　may　be　primarily　associated　with　technical　aspects　of　the　surgery.　When　considering　the　appropriate　treatment　strategy,　percutaneous　endovascular　retrieval　may　be　considered　first.　However,　risks　and　benefits　should　be　carefully　evaluated　on　a　case-by-case　basis.