Increased use of internal jugular and subclacian vein as a venous access route has recently caused an increase in prevalence of thrombotic complications of these veins. Cancers, hypercoagula- ble conditions, infection, peripheral venous lines, intravenous drug abuse and trauma are other well known risk factors for thrombosis of upper extremity and neck veins. Here, we describe a patient who had chronic obstructive pulmonary disease and developed combined thrombosis of left internal jugular and subclavian veins just following prolonged and vigorous coughing bouts. The patient was treated initially with intravenous continues heparin infusion and subsequently with oral coumadin with no early complications or late sequels.