Polymeric micelles are ideal carriers for solubilization and targeting applications using hydrophobic drugs. Stability of colloidal aggregates upon injection into the bloodstream is mandatory to maintain the drugs' targeting potential and to influence pharmacokinetics. In this review we analyzed and discussed the most relevant stress mechanisms that polymeric micelles and related colloidal carriers encounter upon injection, including (1) dilution, (2) interactions with blood components, and (3) immunological responses of the body. In detail we analyzed the opsonin-dysopsonin hypothesis that points at a connection between a particles' protein-corona and its tissue accumulation by the enhanced permeability and retention (EPR) effect. In the established theory, size is seen as a necessary condition to reach nanoparticle accumulation in disease modified tissue. There is, however, mounting evidence of other sufficient conditions (e.g., particle charge, receptor recognition of proteins adsorbed onto particle surfaces) triggering nanoparticle extravasation by active mechanisms. In conclusion, the analyzed stress mechanisms are directly responsible for in vivo success or failure of the site-specific delivery with colloidal carrier systems.