I read with great interest the prospective study by Johansson et al. [1] published in the European Journal of Internal Medicine, which investigates the association between phosphatidylethanol (PEth) concentration and the risk of first-ever venous thromboembolism (VTE). The study’s finding that elevated PEth levels, a biomarker of alcohol consumption, may be linked to increased VTE risk is a significant contribution to the field of internal medicine. This observation prompts further discussion on the clinical utility of PEth in risk stratification and its potential interplay with other prothrombotic factors.