Fibrillar collagens, the most abundant proteins in the vertebrate body, are involved in a plethora of biological interactions. Plasma protein von Willebrand factor (VWF) mediates adhesion of blood platelets to fibrillar collagen types I, II, and III, which is essential for normal haemostasis. High affinity VWF-binding sequences have been identified in the homotrimeric collagen types II and III, however, it is unclear how VWF recognizes the heterotrimeric collagen type I, the superstructure of which is unknown. Here we present the crystal structure of VWF domain A3 bound to a collagen type III-derived homotrimeric peptide. Our structure reveals that VWF-A3 interacts with all three collagen chains and binds through conformational selection to a sequence that is one triplet longer than was previously appreciated from platelet and VWF binding studies. The VWF-binding site overlaps those of SPARC (also known as osteonectin) and discodin domain receptor 2, but is more extended and shifted toward the collagen amino terminus. The observed collagen-binding mode of VWF-A3 provides direct structural constraints on collagen I chain registry. A VWF-binding site can be generated from the sequences RGQAGVMF, present in the two α1 (I) chains, and RGEOGNIGF, in the unique α2(I) chain, provided that α2(I) is in the middle or trailing position. Combining these data with previous structural data on integrin binding to collagen yields strong support for the trailing position of the α2(I) chain, shedding light on the fundamental and long-standing question of the collagen I chain registry.X-ray crystallography | extracellular matrix V on Willebrand factor (VWF) mediates blood platelet adhesion to sites of vascular damage and is essential for platelet adhesion under conditions of high shear stress. Defective processing and/or mutations in VWF are associated with various haemostatic disorders such as haemolytic uremic syndrome, thrombotic thrombocytopenic purpura, and von Willebrand disease, which is the most common genetic bleeding disorder in humans (1). The mature VWF protein consists of 2,050 amino acid monomers that are disulfide-linked into multimers ranging from 0.5 to 10 MDa in size with the larger multimers being more active in hemostasis. VWF multimer size is regulated by ADAMTS13 through proteolytic cleavage within the VWF A2 domain. Upon vascular damage, the VWF A3 domain interacts with exposed collagens I and III. Subsequent transient interactions between the VWF A1 domain and Glycoprotein Ibα (GPIbα) on the surface of blood platelets reduces platelet velocity to allow subsequent stable platelet adhesion and activation, which ultimately results in thrombus deposition.The crystal structure of the collagen-binding VWF A3 domain has been solved (2-4) and the collagen-binding site within the A3 domain has been mapped in extensive site-directed mutagenesis studies and by NMR (5-7). However, detailed structural information on the VWF-collagen interaction has thus far been lacking.Collagens, the most abundant proteins in mammalian...