Purpose Trauma patients are at an increased risk of developing venous thromboembolism (VTE) with a subsequent increased associated mortality rate, particularly in patients requiring the ICU. There remains significant variability in clinical practice related to use of VTE prophylaxis in trauma patients, as they often have contraindications that greatly affect the timing and consistency of its application. This study aimed to assess the effectiveness of chemical VTE prophylaxis in trauma patients under the ACT Trauma Service. Methodology A prospective review was performed on patients admitted under the ACT Trauma Service from July to November 2022. Included patients were 18 years or older, without a direct contraindication to administration of anticoagulation, who received fixed dose chemical VTE prophylaxis with enoxaparin (40mg or 60mg) for at least 3 doses and underwent subsequent testing of their anti-factor 10A (aFXa) level. Results 187 patients were admitted to the ACT Trauma Service, of which 63 patients were included in the study. 47 patients achieved therapeutic levels of anticoagulation as determined by their aFXa level, and 16 were subtherapeutic. The only statistically significant difference between the 2 groups was weight, with patients in the subtherapeutic group weighing 91.9kg vs 79.1kg in the therapeutic group (p <0.05). 3 patients received 60mg enoxaparin daily. All 3 patients were over 90kg, and all 3 patients achieved target aFXa levels. Conclusion Higher weight significantly correlated with inadequate VTE prophylaxis dosing. Therefore Weight-based dosing of low molecular weight heparin may be more effective in achieving adequate VTE prophylaxis.