Microbial surface components recognizing adhesive matrix molecules (MSCRAMMs) comprise a group of cell surface adhesins that bind specifically to the extracellular matrix (ECM) of host cells. Such binding is a critical event in the pathogenesis of most infectious agents, thus it is a major area of research. Among the ECM components that are specifically recognized by MSCRAMMs are fibronectin-, fibrinogen-, collagen-and heparin-associated polysaccharides. The binding, structural organization and pathogenic implications of these interactions are discussed.