Understanding cell transport and adhesion dynamics under flow is important for many biotransport problems. We investigated the influence of cell size, ligand coating density, micropost size, and intercellular collisions on circulating tumor cell adhesion and transport in microfluidic devices. The cells were modeled as coarse-grained cell membranes and the adhesion was modeled as pairwise interacting potentials, while the fluid was solved using the lattice Boltzmann method. The coupling between the cell and the fluid was achieved through the immersed boundary method. The cell showed transient rolling adhesion in high shear regions and firm adhesion in low shear regions. The adhesive force for rolling cells on a micropost was increasing before the cell reached the crest of the post and then decreasing afterward. The adhesive strength for cells increases with ligand coating density. Cell trajectories in a microfluidic device with a shifted post design were studied as well. At low concentrations, the majority of the cells follow streamlines closely. However, the intercellular collision and collision from red blood cells impacted the cell trajectories. An L 2 norm of | e | was defined to characterize the difference between the cell trajectories and the associated streamlines. It was shown that | e | L 2 increases with micropost sizes and cell concentrations.