The microenvironment theory has become very popular for providing mechanisms which explain the development of often lethal posttraumatic complications such as systemic inflammatory response syndrome (SIRS), adult respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS). With the recent advances in molecular biology and the ever-expanding understanding of trauma pathophysiology, immunomonitoring in trauma patients attempts to characterise and quantify novel molecules in order to predict patients at risk. This review article assesses the existing evidence on the biomarkers of endothelial injury and their potential utility as quantification parameters of endothelial dysfunction in trauma patients.