We studied cone and plate(let) analysis (CPA) for evaluating global platelet function in whole blood under arterial flow conditions (approximately 1,800 seconds(-1)). CPA allows direct visualization and quantitation of platelet adhesion (surface coverage [SC]) and determination of average aggregate size (AS) following brief shearing of a small blood sample (3.2% sodium citrate) in plastic wells. By using blood from healthy volunteers manipulated to alter platelet or RBC counts and blood from patients with myeloproliferative disorders (MPDs), quantitative and qualitative changes in SC and AS were observed. Thrombocytosis resulted in increased SC, whereas erythrocytosis increased AS. The RBC volume (mean corpuscular volume) had no effect. It is interesting that differences in CPA AS were discerned among subgroups of patients with MPD undergoing different treatment regimens. These studies suggest that CPA platelet deposition patterns may provide novel insight into global platelet function during hemodynamic flow.