The important interplay between blood circulation and vascular cell behavior warrants the development of highly sensitive but small sensing systems. The emerging micro electro mechanical systems (MEMS) technology, thus, provides the high spatiotemporal resolution to link biomechanical forces on the microscale with large-scale physiology. We fabricated MEMS sensors, comparable to the endothelial cells (ECs) in size, to link real-time shear stress with monocyte/EC interactions in an oscillatory flow environment, simulating the moving and unsteady separation point at arterial bifurcations. In response to oscillatory shear stress (tau) at +/- 2.6 dyn/cm2, time-averaged shear stress (tauave) = 0 at 0.5 Hz, individual monocytes displayed unique to-and-fro trajectories, undergoing rolling, binding, and dissociation with other monocyte, followed by solid adhesion on EC. Incorporating with cell-tracking velocimetry, we visualized that these real-time events occurred over a dynamic range of oscillating shear stress between +/- 2.6 dyn/cm2 and Reynolds number between 0 and 22.2 in the presence of activated adhesion molecule and chemokine mRNA expression.