Neutrophil infiltration is an important feature in inflammatory scenarios. Before these cells infiltrate tissues, however, they contribute to crucial intravascular events in which neutrophil microdomains mediate heterotypic interactions with endothelial cells, red blood cells and/or platelets. In vascular diseases, this can result in exacerbated neutrophil activation, subsequent vascular injury and obstruction of microcirculatory blood flow. This review discusses recent advances in elucidating these neutrophil domains and their associated functions in cell adhesion.