This paper reviews the contribution of scanning electron microscopy (SEM) to our understanding of platelet physiology and pathology. Observations of platelet shape changes which accompany activation and the ability to visualize and analyze platelet aggregation and adhesion in three dimensions make this experimental medium an important tool in the evaluation of healthy and diseased platelets. While SEM adds a valuable third dimension to the study of morphology and ultrastructure, its greatest contribution is realized when studies are correlated directly with light and/or transmission electron microscopic observations and with studies of functional capacity.