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Low plasma vitamin B6, measured as pyridoxal-5’-phosphate (PLP), is associated with an increased risk of first venous thromboembolism (VTE). In a prospective cohort of 757 patients with first VTE we investigated the association of PLP levels with risk of recurrent VTE. After 4 years, the likelihood of VTE recurrence was 22.5% (95% CI 13.6–31.5%) among patients with PLP ≤23.3 nmol/L and 14.4% (11.5–17.4%) among those with PLP >23.3 nmol/L (p=0.01). Patients with PLP ≤23.3 nmol/L had 1.8-fold higher recurrence risk (1.01–3.14) than patients with PLP >23.3 nmol/L (adjusted for confounders including homocysteine). Therefore, low vitamin B6 is a risk factor of recurrent VTE.