Molecular markers for exploring the different stages of hemostasis activation are now available. These markers allow investigation of endothelial functions, blood cell activation, stimulation of coagulation pathways, involvement of the fibrinolytic system, and profiling of the coagulolytic-equilibrium that regulates hemostasis. Additionally, these markers find useful applications for monitoring therapies, following-up clinical states associated with high thrombotic risk, and validating new drugs and analyzing their mode of action. Furthermore, these markers may allow for recognition of the evolution of early disease in the clinically silent phase. Large scale epidemiological and longitudinal studies are required for establishing this latter approach. Up to now, only D. Dimer is used in routine clinical application for exclusion diagnosis of deep-veinous-thrombosis and pulmonary embolism. Other markers must prove their sensitivity for the early asymptomatic period and demonstrate their applicability throughout disease evolution. According to pathology and application, different markers may provide complementary information. Some markers, e.g., D.Dimer, soluble thrombomodulin, and modified AT-III (ATM), are used on standard citrated plasma samples. Modem and flexible technologies are now available for point-of-care testing (when required), quick and sensitive measurements in emergency conditions, and full automation when necessary. Lastly, factors that trigger hemostatic activation can now be evaluated and provide information on etiology. In this latter respect, autoimmunity may be important in thrombotic disease induction.A major unresolved question concerns the evaluation of the activation state of blood and vascularture. Finding an answer would have multiple applications in following evolution of clinical states; evaluating the antithrombotic efficacy of anticoagulant, antithrombotic, and thrombolytic therapies (and, therefore, adjusting the drug dosage and/or establishing the correct therapeutic strategy); and identifying patients who present the highest thrombotic risk in clinical states frequently associated with this complications (1). Furthermore, the ability to evaluate the activation state of blood and vasculature could lead to preventive measures for the general population, and ~i~'er the possibility of selecting individuals in the early stage of disease ~w~-' lution and provide them with appropriate therapy (2). However, applications for the many proposed indicators of blood activation, originating from plasma factors, blood cells, or endothelial stimulation, are still mainly restricted to highly specialized research studies. The reasons for this are multiple and concern the molecular markers themselves as well as the assay methods used for their measurement. Actually, most of these molecular markers are present at very low concentrations, are frequently generated only in the symptomatic period, present usually with very short half-lives, and are ' very often sensitive to ex vivo blood activation, which...