SummaryPhotodynamic therapy (PDT) has both direct cell and indirect vascular effects. Both are well established and the latter has given rise to specifically target angiogenesis in PDT treatments. While the vascular effects are well understood, further advances in antiangiogenesis require a detailed understanding of PDT effects at the microvasculature level. Although some of the earliest investigations of PDT noted effects on platelet aggregation the importance of their interaction with endothelial cells and the crucial role of various signaling pathways is only now emerging. This review aims to give a general overview of PDT related studies on platelets, vascular effects, and their interaction with endothelial cells to indicate the potential for studies in this area.Abbreviations: ALA --aminolevulinic acid; AMD -age-related macular degeneration; ANET -anti-neovascular therapy; BGF -basic fibroblast growth factor; DHEdihaematoporphyrin ether; EDRF -endothelium-derived relaxing factor; epithelial growth factor -EGF; HIF-1 -hypoxia-inducible factor 1; HpD -haematoporphyrin derivative; IL -interleukin; PAF -platelet activating factor; PDT -photodynamic therapy; PS -photosensitizer; transforming growth factor 1 -TGF-1; TNF -tumor necrosis factor.