Liposomes such as Doxil are currently used in clinics to achieve such benefits in cancer treatment while other lipid nanoparticles (LNP) carrying messenger RNA (mRNA) find potential use as safe and effective vaccines. [4-6] A relevant example is the recent approval of an mRNA LNP vaccine candidate by the U.S. Food and Drug Administration for the first clinical trial against the 2019 coronavirus (SARS-CoV-2). [7,8] In addition, polymeric nanoparticles have demonstrated a wide variety of applications ranging from drug and gene delivery to nanocarriers for imaging contrast agents and non-opioid drugs to treat chronic pain. [9-11] In the majority of these applications, nanoparticles first interact with human blood in blood vessels before reaching disease targets (tissues or cells). [12] For example, upon administering Doxil nanoparticles, they interact with human blood during circulation, and only a small proportion of these nanoparticles can accumulate in tumors. [13-15] While interactions of nanoparticles with cancer cells have been extensively studied, their interactions with healthy cells in human blood and blood vessels remain unclear as it is challenging to study. [16] Understanding such important A key concept in nanomedicine is encapsulating therapeutic or diagnostic agents inside nanoparticles to prolong blood circulation time and to enhance interactions with targeted cells. During circulation and depending on the selected application (e.g., cancer drug delivery or immune modulators), nanoparticles are required to possess low or high interactions with cells in human blood and blood vessels to minimize side effects or maximize delivery efficiency. However, analysis of cellular interactions in blood vessels is chal lenging and is not yet realized due to the diverse components of human blood and hemodynamic flow in blood vessels. Here, the first comprehensive method to analyze cellular interactions of both synthetic and commercially available nanoparticles under human blood flow conditions in a micro vascular network is developed. Importantly, this method allows to unravel the complex interplay of size, charge, and type of nanoparticles on their cellular associations under the dynamic flow of human blood. This method offers a unique platform to study complex interactions of any type of nanoparticles in human blood flow conditions and serves as a useful guideline for the rational design of liposomes and polymer nanoparticles for diverse applications in nanomedicine.