Venous thromboembolism (VTE) outcomes are influenced by various factors, including race and geographic location. This study aimed to evaluate the associations between race, geographic location, and VTE-related outcomes using real-world data.We analyzed data from 42,206 patients with acute VTE enrolled in the RIETE registry between June 2016 and June 2024. Patients were categorized by self-reported race/ethnicity: White (40,258), Arab (995), Asian (689), and Black (264). Baseline characteristics, comorbidities, treatment strategies, and outcomes (including recurrences, major bleeding, and mortality) were compared across groups and regions. Multivariable analyses were performed to adjust for confounders, including geographic location and comorbidities.Arabic and Asian patients were generally younger, had fewer comorbidities, and were more likely to receive direct oral anticoagulants than White patients. In unadjusted analysis, non-White patients had higher rates of deep vein thrombosis (DVT) recurrence and mortality. After multivariable adjustment, most differences disappeared. Notably, White patients enrolled in Asian centers had higher DVT recurrence (4.54 vs. 1.10/100 patient-years, respectively) and mortality rates (27.9 vs. 8.88/100 patient-years, respectively) than those in European centers, and Arab patients in Asia had higher mortality compared to those in Europe (24.1 vs. 8.26/100 patient-years, respectively).Geographic location, likely representing healthcare infrastructure, had a greater influence on VTE outcomes than self-reported race alone.