SummaryDuring the prolonged course of atherosclerotic disease,platelets areofcentral importanceastheycontribute to the initiation of the disease,toi ts progressiona nd acutee xacerbation but also providep otentialr egenerativem echanisms. Platelets secrete chemokinesa nd cytokinest hatm ediatev ascular inflammation andare in turn activated by substances released from cells of the vascularwall.These interactions represent positive andnegative feedback loops, whichincaseofdysregulationmay lead to development andp rogression of disease.Furthermore, platelet adhesion to the endothelium is critical forthe initiation of atherosclerotic lesion formation in vivo.Evenp rior to endotheliald enudation, plateletadhesion governed by disturbedflowatpredilection sites foratherosclerosisinduces recruitment of proatheKeywords Atherothrombosis, plateletphysiology, stemcells rosclerotic cells andrelease of proinflammatory mediators from allinvolved cell types.Finally, the pathogenetic role of platelets for late atheroclerotic eventsincluding plaque rupture,microembolism or spasms withint he microcirculationi sw elle stablished. However, increasing evidence indicatesthatplatelets mediateon the other hand potential regenerativemechanisms. Platelets recruit circulating progenitor cells to sites of vasculari njury. Furthermore,theyinfluencetheir biological activity andmaturation. Therefore,platelets contribute at allstages of vasculardiseaseby interfering with highlyd ynamic processes. Understanding interactions of plateletswith othercirculatingcells andt he vascular wall is aprerequisite to understand cardiovascular disease andto identify potentialtherapeutic targets.