Venous thromboembolism (VTE) is a common, complex, and costly complication in cancer patients undergoing surgery. VTE risk varies with types of cancer surgery as well as patient-, cancer-, and treatment-associated factors. Current VTE preventive measures with pharmacological, mechanical, and combination of both are shown to be effective. Clinical questions remain and more research is needed, focusing on the role of thromboprophylaxis for minimally invasive surgery and major cancer surgery other than abdominal/pelvic surgery, as well as optimal duration of thromboprophylaxis in high-risk patients. Routine individual VTE risk assessment and better adherence to thromboprophylaxis guidelines may offer improved outcomes in cancer patients undergoing surgery. A summary of currently available evidence and consensus guidelines on the primary prevention of VTE in cancer patients undergoing various types of surgery is presented here.