During an inflammatory response, changes in the adhesive properties of the endothelium occur that enable normally non-adherent blood-borne leukocytes to adhere and subsequently to traverse the endothelium through small gaps at inter-cellular junctions. This review concentrates on the role played by inter-endothelial adhesion molecules during transmigration and the way in which their expression may be regulated during inflammation. We show that the final "open" signals that lead to the formation of clefts between adjacent endothelial cells may be derived from inflamed tissue underlying the endothelium and from activated leukocytes.