We investigated whether human peripheral blood mononuclear cells (PBMC) express prothrombinase following stimulation with bacterial lipopolysaccharide (LPS). LPS-stimulated PBMC devoid of contaminating platelets failed to activate prothrombin directly. Addition of platelets did not result in expression of prothrombinase in the absence of factor X whereas the combination of platelets and factor X resulted in strong prothrombinase activity on LPS-activated cells. The induced prothrombinase was dependent on tissue factor, as the activity was completely inhibited by an anti-tissue factor antibody. Our data suggest that platelet/monocyte cooperation is important in the generation of prothrombinase activity in response to endotoxin.