Platelet adhesion and aggregation play a pivotal role in the physiopathology of acute coronary syndromes. Inhibitors of the GPIIb/IIIa receptors block the final step of platelet aggregation. Clinical trials have demonstrated efficacy of these drugs to reduce ischemic complications after percutaneous coronary interventions. In the setting of acute coronary syndromes without persistent ST segment elevation, abciximab improves outcomes in case of revascularization. Tirofiban and eptifibatide limit ischemic complications in the same setting, with additional effect in patients undergoing angioplasty. Blockers of the GPIIb/IIIa receptors should be the standard of care of patients with acute coronary syndromes. The optimal therapeutic strategy should include, after proper risk stratification, an early medical approach combined with an early revascularization.