Adhesion of neutrophils to vascular endothelial cells (ECs), mediated by the interaction of CD11/CD18 and intercellular adhesion molecule-1 (ICAM-1), is often required for neutrophil transmigration across endothelium during most inflammatory responses. Induction of intracellular signaling in neutrophils as a result of adhesion has been recognized for many years. Recent studies demonstrated that neutrophil-endothelial adhesion also activates ECs. Examples of neutrophil adherence-induced changes in ECs include increases in intracellular Ca(2+), production of reactive oxygen species, and actin cytoskeleton changes. These changes result, in part, from ligation of EC adhesion molecules. This review article focuses on the signaling events that occur in ECs during neutrophil adhesion and the role of EC adhesion molecules, particularly ICAM-1, in the initiation of these signaling events in ECs. The evidence to date describing the molecular basis of ICAM-1-induced signaling will be summarized. Finally, the potential physiological roles of these signaling events induced by EC adhesion molecules in mediating neutrophil migration will be addressed.