The exudation of neutrophils is the hallmark of a form of inflammatory response occurring after tissue colonization by invading bacteria or as an expression of various non-infectious diseases. All these diseases are characterized by a high risk of developing irreversible tissue injury. Neutrophil-endothelium interactions, activation-induced functional and structural changes of responding neutrophils, regulatory systems of neutrophil function, and oxidative-proteolytic pathways responsible for histotoxicity are reviewed here. Finally, perspectives for rational approaches to handle the development of tissue injury during neutrophilic inflammation are considered.