Background-Inflammation plays an important role in the response to endoluminal vascular injury. Estrogen (17-estradiol, E 2 ) inhibits neointima formation in animal models, and the progestin medroxyprogesterone acetate (MPA) blocks this effect. This study tested the hypothesis that E 2 inhibits the migration of inflammatory cells, particularly granulocytes, into the rat carotid arteries after acute endoluminal injury and that MPA blocks this effect. Methods and Results-Ovariectomized rats were randomly divided into subgroups and treated with E 2 , MPA, E 2 ϩMPA, or vehicle and subjected to balloon injury of the right carotid artery. After 1, 3, or 7 days, rats were euthanized, and carotid arteries (injured and control) were analyzed for inflammatory cells by flow cytometry. At 1 day, granulocytes (HIS48 ϩ and CD45 ϩ ), monocyte/macrophages (Mar1 ϩ and CD45 ϩ ), and T lymphocytes (CD3 ϩ and CD45 ϩ ) were increased 26-fold, 12-fold, and 3-fold, respectively, in injured compared with contralateral control arteries of vehicle-treated rats. Granulocytes and monocyte/macrophages decreased markedly by 3 days. E 2 reduced the granulocyte and monocyte/macrophage populations of injured vessels by Ϸ50% and increased T lymphocytes. MPA had no independent effect on inflammatory cells but completely blocked the effect of E 2 . Immunohistochemical examination verified these findings and localized inflammatory cells to the adventitial and periadventitial domains of injured vessels. Conclusions-E 2 may limit the neointimal response to endoluminal vascular injury, at least in part, by limiting leukocyte entry from adventitial/periadventitial tissues into injured vessels early in the injury response.