A variety of adhesive interactions must take place between the tumor cell and the host vasculature in order to potentiate both tumor expansion and metastatic tumor spread. The study of tumor cell and blood vessel adhesive interactions becomes essential for our understanding of the malignant process, especially with regard to organ-specific tumor metastasis. In this article we will review recent progress made in our understanding of the nature of (i) receptor mediated adhesion of endothelial cells to extracellular matrix components and (ii) adhesion of tumor cells to endothelial adhesion molecules and to components of the subendothelial basement membrane.