Survivin is a member of the inhibitor of apoptosis (TAP) gene family that exhibits differential expression in nearly all human cancers but not in most normal tissues. Recent progress identified a multifunctional survivin pathway positioned at the interface between mitotic progression and apoptosis inhibition, and required to preserve viability of dividing tumor cells (Altieri, 2001; Andersen and Thor, 2002; Jaattela, 1999). The unique properties of survivin have recently found concrete applications for cancer detection, diagnosis, and outcome prediction. In addition, targeting the survivin pathway may offer new therapeutic prospects to lower a general survival threshold in cancer cells. This chapter will focus on the current developments in the field of survivin and its role in apoptosis regulation and mitotic progression. Current perspectives on exploiting the survivin pathway for cancer diagnosis and treatment will be highlighted.