Megakaryopoiesis is the process by which bone marrow progenitor cells develop into mature megakaryocytes (MKs), which in turn produce platelets required for normal hemostasis. Over the past decade, the molecular mechanisms that contribute to MK development and differentiation have begun to be elucidated. In this review, we provide an overview of megakaryopoiesis and summarize the latest developments in this field. Specially, we focus on polyploidization, a unique form of the cell cycle that allows MKs to increase their DNA content, and the genes that regulate this process. In addition, since megakaryocytes play an important role in the pathogenesis of acute megakaryocytic leukemia (AMKL) and a subset of myeloproliferative neoplasms (MPNs), including essential thrombocythemia (ET) and primary myelofibrosis (PMF), we discuss the biology and genetics of these disorders. We anticipate that an increased understanding of normal megakaryocyte differentiation will provide new insights into novel therapeutic approaches that will directly benefit patients.