We prove Pieri formulas for the multiplication with special Schubert classes in the K-theory of all cominuscule Grassmannians. For Grassmannians of type A this gives a new proof of a formula of Lenart. Our formula is new for Lagrangian Grassmannians, and for orthogonal Grassmannians it proves a special case of a conjectural Littlewood-Richardson rule of Thomas and Yong. Recent work of Thomas and Yong and of E. Clifford has shown that the full Littlewood-Richardson rule for orthogonal Grassmannians follows from the Pieri case proved here. We describe the K-theoretic Pieri coefficients both as integers determined by positive recursive identities and as the number of certain tableaux. The proof is based on a computation of the sheaf Euler characteristic of triple intersections of Schubert varieties, where at least one Schubert variety is special.