IntroductionPlatelet endothelial cell adhesion molecule-1 (PECAM-1) is a 130-kD member of the immunoglobulin (Ig) superfamily that is expressed on the surface of circulating platelets, monocytes, neutrophils, and selected T cell subsets. It is also a major constituent of the endothelial cell intercellular junction (1-3), where up to 10 6 PECAM-1 molecules (4) are concentrated. With a few minor exceptions, PECAM-1 is not present on fibroblasts, epithelium, muscle, or other nonvascular cells. Since its cloning nearly 10 yr ago (5, 6), much has been learned about the structure of this cell adhesion receptor and its function in vascular cells. The purpose of this brief Perspective is to review progress in the field of PECAM-1 biology, and to bring the reader up to date on current concepts about ( a ) the function of PECAM-1 in the different vascular cells in which it is expressed; ( b ) the molecular mechanisms by which PECAM-1 mediates cell-cell interactions; and ( c ) its role in bidirectional transmembrane signal transduction. In keeping with the intent of this series to discuss issues of cell adhesion in the context of human biology and pathophysiology, the potential clinical relevance of PECAM-1-mediated cellular interactions to thrombotic, inflammatory, and immunological diseases will be underscored at relevant points throughout the review.