In the last 20 years, the cellular and molecular mechanisms of inflammation and thrombosis have been characterised. These are essentially cell adhesion processes which are regulated by vascular endothelium. Many of the cell adhesion molecules and leucocyte chemoattractants expressed and generated at sites of inflammation have been sequenced and cloned. These inflammatory molecules work together in concert to mediate the adhesion between leucocytes, platelets and vascular endothelium which occurs during the occlusive, thromboembolic, reperfusion and septic complications of atherosclerotic and diabetic vascular diseases. This review aims to summarise our current understanding of the molecular basis of these disorders and the therapeutic implications.