Cells interact with their extracellular environment and each other in crucial ways. The glycocalyx and extracellular matrix (ECM) allow cell-cell and cell-substrate communication through molecules like integrins, selectins, and immunoglobulins. Integrins link the ECM to the cytoskeleton, forming structures like focal adhesions and hemidesmosomes that mediate adhesion and sensing. The ECM is a network of proteins and sugars including collagens, proteoglycans, fibronectin, and laminins that provide structure, regulate cell behavior, and facilitate processes like tissue formation and wound healing. Abnormalities in these interactions can lead to diseases.