Extracellular vesicles (EVs) are emerging as pivotal players in the regulation of hemostasis and the pathogenesis of thrombosis. This talk explores the biogenesis and molecular cargo of EVs, their interactions with platelets, endothelial cells, and coagulation factors, and their dual role as both biomarkers and mediators of thrombotic risk. By examining recent advances in EV profiling and functional assays, we will discuss how these vesicles contribute to clot formation, vascular integrity, and inflammatory signaling, and consider their potential as therapeutic targets in thrombotic disorders.