Most agonists stimulate platelet Ca 2+ rises via G-protein coupled receptors (GPCRs) or ITAMlinked receptors (ILRs). Well studied are the GPCRs stimulated by the soluble agonists thrombin (PAR1, PAR4), ADP (P2Y 1 , P2Y 12 ), and thromboxane A 2 (TP), signaling via phospholipase (PLC)β isoforms. The platelet ILRs glycoprotein VI (GPVI), C-type lectin-like receptor 2 (CLEC2), and FcγRIIa are stimulated by adhesive ligands or antibody complexes and signal via tyrosine protein kinases and PLCγ isoforms. Marked differences exist between the GPCR-and ILRinduced Ca 2+ signaling in: (i) dependency of tyrosine phosphorylation; (ii) oscillatory versus continued Ca 2+ rises by mobilization from the endoplasmic reticulum; and (iii) smaller or larger role of extracellular Ca 2+ entry via STIM1/ORAI1. Co-stimulation of both types of receptors, especially by thrombin (PAR1/4) and collagen (GPVI), leads to a highly enforced Ca 2+ rise, involving mitochondrial Ca 2+ release, which activates the ion and phospholipid channel, anoctamin-6. This highly Ca 2+ -dependent process causes swelling, ballooning, and phosphatidylserine expression, establishing a unique platelet population swinging between vital and necrotic (procoagulant 'zombie' platelets). Additionally, the high Ca 2+ status of procoagulant platelets induces a set of additional events: (i) Ca 2+ dependent cleavage of signaling proteins and receptors via calpain and ADAM isoforms; (ii) microvesiculation; (iii) enhanced coagulation factor binding; and (iv) fibrin-coat formation involving transglutaminases. Given the additive roles of GPCR and ILR in Ca 2+ signal generation, high-throughput screening of biomolecules or small molecules based on Ca 2+ flux measurements provides a promising way to find new inhibitors interfering with prolonged high Ca 2+ , phosphatidylserine expression, and hence platelet procoagulant activity.