Purpose Duplex ultrasound presents a quick, non-invasive investigation for deep venous thrombosis (DVT), and its use has expanded over the years with the prevalence of vascular ultrasound laboratories. We assessed the volume of requests, rates of positive scans and surgical intervention at our centre with a cost-analysis to characterise the overall impact on the healthcare system. Methodology We conducted a retrospective cohort analysis of all DVT exclusion requests at our institution from January to May 2026. The primary outcome was scan demonstrating acute DVT, with secondary outcome of referral for consideration of surgery. Results A total of 613 scans were conducted over 5 months, with 350 for inpatients, 194 outpatients and 69 in the emergency department. There were 213 unilateral lower limb, 256 bilateral lower limb and 144 upper limb (unilateral) requests. 99 noted previous DVT (16.3%), 56 had diagnosed pulmonary embolism (PE) (9.1%), and 54 noted recent venous cannulation. 94 scans reported acute DVTs (29 upper and 65 lower limb, 15.3%), with 38 of those in patients with PE. 40 out of 59 acute DVTs involving femoral or upper limb veins were referred for surgical opinion. Notably, 38 requests were for “screening” (6.2% of total requests), 13 of which found a DVT, and 151 requests had no significant clinical information with 19 finding an acute DVT (12.6%). With the current Medicare schedule fee for acute DVT scan being $194.65 and up to 95% rebate for a bulk billed scan, we estimated an overall cost over 110,000AUD over 5 months to Medicare for 5 months of DVT exclusions studies in our centre. Conclusion DVT exclusion duplexes at our institution demonstrated appropriate diagnostic yield (15.3% positive rate), and 42.6% of those with acute DVT were also referred for surgical opinion. Whilst DVT exclusion studies do have a significant cost to the taxpayer, their use at our centre does seem appropriate in the context of a significant pathology.