Arenaviridae, Bunyaviridae, Filoviridae and Flaviviridae are all RNA viruses that can induce a coagulopathy in infected patients. While there is a paucity of information on the cause of this coagulopathy, these viruses all produce a severe thrombocytopenia. Here, we review the literature on viral hemorrhagic fever and discuss the role played by platelets in the coagulopathy. We also discuss the possibility of using anti-platelet agents to moderate the coagulopathy, a strategy that might have a role to play in treating patients infected by these viruses.