Intimal Platelets are thought to play a major role in the formation of arterial intimal lesions (1, 2) by releasing, at sites of endothelial denudation, growth factors that stimulate smooth muscle cell (SMC) growth. Support for the role of platelets in vivo comes from the key study of Friedman et al. (3), in which these authors showed that experimentally induced intimal lesion formation in rabbit arteries was significantly inhibited by prolonged thrombocytopenia. This study was interpreted by others to suggest that platelets play an important role in the induction of SMC replication, even though no cell cycle data were presented. An alternative hypothesis is that platelets and their mitogens were important in initiating migration of cells into the intima. In this regard, platelet-derived growth factor (PDGF) has been shown to be chemotactic for mesenchymal cells (4,5). The goal of this study was to determine whether, after balloon catheter denudation, inhibition of platelet adherence influenced SMCs in terms of early mRNA expression and cell proliferation. To accomplish this, we used a single injection of a polyclonal antibody against rat platelets that prevented their adherence to the subendothelium for more than 24 hr after injury. Using this protocol, we were able to show that the absence of platelets did not affect the early proliferation of SMCs in response to injury but did inhibit formation of intimal lesions. We conclude that after balloon catheter injury platelets play a minor role in promoting medial proliferation but are important in the stimulation of SMC migration into the intima.