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This review presents current knowledge about the effects of fluid mechanical shearing stress on receptor-mediated cellular interactions relevant to the processes of inflammation and cancer metastasis, two of the most critical pathological disorders affecting humankind today. Specifically, the multistep sequential models describing leukocyte-endothelium/platelet and tumor cell-endothelium/platelet interactions are discussed, with an emphasis on the similarities and differences amongst these processes. Elucidation of the complex interplay among blood flow, cell adhesion, and vascular biology at the molecular level will have an impact in the search for cellular/tissue engineering based therapeutic interventions against inflammatory and metastastic disorders.