La vaso-oclusion en la drepanocitosis es una caracteristica unica entre las anemias hemoliticas. La idea de que el eritrocito falciforme induce el proceso vaso-oclusivo ha sido desechada y no cabe duda que el fenomeno ocurre debido a la adhesion de los hematies deformables menos densos (reticulocitos de stress) al endotelio vascular activado en las venulas post-capilares, proceso en el que participan moleculas de adhesion celular (MAC) eritrocitarias y vasculares asi como un conjunto de factores plasmaticos; la externalizacion de la fosfatidilserina, la accion de la trombina, la expresion de factor tisular asociada a alteraciones del mecanismo de transporte cationico, conjuntamente con la formacion de agregados de banda 3 constituyen un conjunto de elementos cruciales en la explicacion fisiopatologica de la vaso-oclusion y su relacion con diferentes opciones terapeuticas. Palabras clave: Vaso-oclusion, drepanocitosis, moleculas de adhesion celular, molecula banda 3. ABSTRACT The vaso-occlusion in the sickle cell anemia is only characteristic in the haemolytic anemias. The idea that the falciform erythrocyte induces the vaso-occlusive process has been abolished and without doubt the event is produced by the adhesion of the low density deformed erythrocytes ( stress reticulocytes ) to the active vascular endothelium in post-capillary venule participating in the process molecules of cellular adhesion ( erythrocytic and vascular) as well as a group of plasma factors; the external phosphatidilserine , the thrombine action , the expression of tissue factor associated to the disorders of the cationic transportation mechanism as well as the aggregates (band 3) are crucial elements in the pathophysiological explanation of vaso-occlusion and its relation to different therapeutic options. Key words: Vaso-occlusion,sickle cell anemia, cellular adhesion molecules, band 3 molecule