Cardiovascular disease is the main cause of death and disability in the Western society. Lipoproteins play an important role in the development of this disease and affect different cell types involved in atherosclerosis and thrombosis. Based on their density, five classes of lipoproteins have been identified which all influence cells via distinct mechanisms. Modification turns lipoproteins into atherogenic particles with a prominent role in atherogenesis. The interaction of lipoproteins with platelets has been under investigation for a number of years. Especially the role of LDL in platelet signaling has been studied intensively as platelets of hypercholesterolemic patients are hyperreactive and show hyperaggregability in vitro and enhanced activity in vivo, suggesting that LDL enhances platelet responsiveness. Several signaling pathways induced by LDL have been revealed in vitro, such as signaling via p38 mitogen-activated protein kinase (p38MAPK) and p125 focal adhesion kinase (p125FAK). HDL opposes the activating properties of LDL on platelets, whereas the effects of chylomicrons, VLDL or IDL on platelet function are controversial. Modification of lipoproteins is associated with the generation of new constituents with new signaling properties. In particular, the plateletactivating properties of lysophosphatidic acid, which is a constituent of atherosclerotic plaques and is generated upon oxidation of LDL, have been investigated intensively. This review provides a summary of the activation of signaling pathways after platelet-lipoprotein interactions, with special emphasis on the role of these interactions in the development of thrombosis and atherosclerosis.