Platelet transfusion, as the primary treatment for severely low platelet count (thrombocytopenia) or disorders of platelet function, is used extensively in patients with blood system diseases or active hemorrhaging. In recent decades platelet related researches in China have steadily increased. In the clinical application of platelet transfusion, there are large differences between the treatment’s effects on different patients. Immune or nonimmune factors, such as platelet-specific antibodies, platelet gene analysis and matches, and auxiliary treatment, may affect the curative effect, and even result in ineffective platelet transfusion. Platelets used in clinical therapy include platelets made from whole blood and hemapheresis platelets, and the latter is the main application type used in China. Both preparation and preservation methods can affect the quality of platelets and influence the therapeutic effect. Researches on the molecular basis or the curative effect of platelet transfusion are increasing, such as the relationship between platelet-activating factors, tissue factors, thrombopoietin, membrane glycoprotein and platelet activation, and their influence on the curative effect of platelet transfusion, the inhibition of antiplatelet therapy in platelet activation, and platelet signal transduction pathways and their significance in the curative effect of platelet transfusion. This article aims to review the research progress on the curative effect of platelet transfusion and its molecular mechanisms.