The ability of vascular endothelial cells (ECs) to respond to changes in blood flow is essential for both vasoregulation and arterial wall remodelling, while abnormalities in endothelial responsiveness to flow play an important role in the development of atherosclerosis. Endothelial flow responses also have important implications for the field of vascular tissue engineering. In response to changes in fluid dynamic shear stress, ECs exhibit humoral, metabolic, and structural responses. Significantly, ECs respond differently to different types of shear stress. For instance, steady shear stress elicits a profile of responses that differs drastically from oscillatory shear stress. Although our understanding of flow-induced signaling has advanced greatly over the past two decades, how ECs sense shear forces remains to be established. Furthermore, the mechanisms by which ECs discriminate among different flow waveforms are unknown. Activation of flow-sensitive ion channels is one of the most rapid known responses to flow in ECs. In this paper, we argue in favor of an important role for ion channels in shear stress sensing in ECs and propose that these channels may endow ECs with the ability to resolve components of a complex flow signal and hence distinguish among different types of flow.