Platelets play an invaluable role in hemostasis. After vessel injury, platelets arrest, activate, and form a platelet plug essential for sealing the site of insult and preventing excessive blood loss. However, insufficient or excessive platelet activation can both lead to pathologies. Therefore, platelet activity is tightly regulated. Platelets express a wide variety of receptors that enable their response to diverse physiological and pathological stimulants. The glycoprotein (GP)Ib-IX complex is the second most abundant platelet surface receptor. 1,2 GPIb-IX is a major platelet mechanoreceptor and participates in several diverse functions including adhesion, activation, clearance, and thrombopoiesis. This review covers GPIb-IX's structure and function, with an emphasis on advances made in the last decade. 2 | S TRUC TURE AND ORG ANIZ ATI ON OF G PIb-IX The glycoprotein (GP)Ib-IX is a highly integrated hetero-tetrameric receptor complex containing three unique subunits: GPIbα, GPIbβ, and GPIX, arranged in a 1:2:1 stoichiometry. 3 Each subunit is an independently expressed transmembrane protein with a short cytoplasmic tail, a single transmembrane domain, and a glycosylated extracellular domain. 4 Efficient expression of the GPIb-IX complex on the platelet membrane depends on co-expression of all subunits. 5,6 GPIb-IX also associates with GPV, likely at a 1:1 stoichiometry, but the association is relatively weak and can be disrupted by nonionic detergents. 7 GPIbα is the "business end" of the complex, by far the largest subunit, and responsible for binding to almost all known ligands of the complex. At its extracellular N-terminus, GPIbα begins with a ~45-kDa domain containing seven leucine-rich repeats (LRR), also known as the ligand-binding domain (LBD) (Figure 1). The C-terminal portion of the LBD contains a small "thumb" region crucial for effective binding to the A1 domain of von Willebrand factor (VWF). 8 Following the LBD is a short anionic stretch involved in thrombin binding and a flexible stalk known as the macroglycopeptide or sialomucin region, spanning 30-40 nm. 4 The sialomucin region is characterized by a variable number of tandem repeats and its excessive O-glycosylation which, by some estimates, accounts for as much as 70% of the entire sialic acid content on the platelet surface. 9 It helps raise the LBD high above the platelet membrane and facilitates its