Pulmonary embolism can be a challenging condition for physicians to manage. They often have to diagnose this disease with a high fatality rate via the presence of non-specific symptoms. Another unusual presentation is abdominal pain, which can delay diagnosis due to a broad differential.We report the case of a 30-year-old female with a history of sickle cell anemia who presented to the Emergency Department with several days of right flank pain and urinary symptoms. Unfortunately, her initial urine analysis and chest radiograph could have been misdiagnosed as pyelonephritis. Early diagnosis and timely treatment are critical factors in reducing the mortality rate from pulmonary embolism.