The analysis of cellular markers for the assessment of cardiovascular risk is a new concept emerging from research on the cell biology of atherosclerosis. The most promising aspects relate to the investigation of abnormal activation and differentiation of cells involved in the atherosclerotic process isolated from peripheral blood, for example, monocytes and platelets. In addition, several plasma proteins have been identified as markers for cellular processes or immunologic activation. These are potential candidates for an improved identification of individuals at increased risk. The lack of specificity and sensitivity of the currently available parameters for individual risk assessment require further search for more specific risk markers. Furthermore, it will be necessary to develop strategies to reliably monitor therapeutic interventions. This review will focus on potential future directions to establish cellular markers for these purposes.