Thrombopoietin (TPO) was first described as an activity in thrombocytopenic serum that could stimulate platelet production upon transfer into other animals. The molecular cloning of TPO has allowed a detailed characterisation of its precise biological activities, both in vitro and in vivo. TPO binds its specific receptor, the c-Mpl protein, which is expressed on the surface of target cells, and induces receptor dimerization and activation of intracellular signalling pathways including the Janus kinase (JAK)-signal transducers and activators of transcription (STAT) and Ras cascades. TPO is a lineage-dominant cytokine, stimulating megakaryocyte production and maturation in vitro and inducing the greatest elevation in platelet numbers of any known cytokine upon administration to humans or laboratory animals. Indeed, gene targeting studies have established that the TPO/c-Mpl signalling system is the major physiological regulator of steady-state megakaryocyte and platelet production. These studies have also revealed a largely unanticipated role for TPO in the regulation of hemopoietic stem cells. Preclinical studies in animal models have indicated the capacity of c-Mpl ligands to overcome the thrombocytopenia associated with chemo/radiotherapy and clinical trials have already demonstrated the safety and efficacy of Mpl-ligands in elevating platelet counts in humans. It is likely that these molecules will lead to new therapeutics that will find utility in a range of clinical contexts.