Cancer patients have a four- to seven-fold increased risk to develop a venous thromboembolic event. Accumulating evidence from experimental and clinical studies indicates that microparticles (MPs), small procoagulant membrane vesicles that are defined by size and a negatively charged phosphatidylserine rich surface, play an important role in the pathogenesis of cancer-related venous thromboembolism (VTE). However, the clinical significance of MPs as a predictive biomarker for VTE in cancer patients has not been fully elucidated yet. This might be due to unresolved methodological problems and a lack of data from large prospective clinical studies that investigate the role of MPs in cancer-related VTE. It is the aim of this review to give an overview on the most important characteristics of MPs and studies dealing with the role of MPs in cancer-related VTE. Also recent progresses, unresolved problems and future perspectives in this research field will be discussed. In the conclusion we will assess the clinical significance of MPs in cancer-related VTE.