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Platelet secretion is central to physiological and pathophysiological platelet function. SNAP23 has long been implicated as being a principal SNARE protein regulating platelet granule secretion, although this has not been definitively demonstrated in genetic models. Here, using a platelet-specific conditional SNAP23 knockout mouse, we show that absence of SNAP23 results in complete ablation of dense granule, α granule, and lysosomal secretion. Measured granule cargo content and granule numbers were normal, suggesting SNAP23 regulates fusion of granules with the extracellular membrane, rather than granule loading or formation. A macrothrombocytopenia was also observed, which, combined with ablation of secretion, resulted in a pronounced bleeding defect in a tail bleed assay and almost complete ablation of arterial and venous thrombosis. The macrothrombocytopenia was not due to reduced megakaryopoiesis but instead likely was due to the increased loss of platelets through bleeding, consistent with an increase in platelet total RNA content indicating a greater number of reticulated platelets. The data definitively show SNAP23 to be critical for granule release of any kind from platelets, irrespective of stimulus, and this is the first single gene to be shown to be universally essential for exocytosis in platelets., (© 2018 by The American Society of Hematology.)