Platelets, traditionally known for their role in hemostasis and thrombosis, have emerged as key regulators of angiogenesis through the storage and release of diverse pro- and anti-angiogenic factors. This review explores the dual role of platelets in promoting and inhibiting angiogenesis in both physiological processes such as wound healing, embryogenesis, and menstruation, as well as in pathological conditions including cancer, atherosclerosis, diabetic retinopathy, among others. Platelet-mediated angiogenesis encompasses several mechanisms, including the selective release of growth factors in scenarios like cancer, which highlights the complex interplay between platelets and vascular biology. We also discuss potential therapeutic implications, such as anti-angiogenic treatments and platelet-rich plasma applications in managing angiogenesis-related disorders.