Apoptosis (programmed cell death) of vascular smooth muscle cells and macrophages has recently been demonstrated in the following: (a) human atherosclerotic plaques; (b) physiological remodelling of the vessel; and (c) a variety of disease states. Apoptosis is a highly regulated mechanism of death, controlled by the interactions between the following: (i) cellular receptors; (ii) cytoplasmic and nuclear gene products; and (iii) the local cytokine and cellular environment within the plaque. The knowledge of the key regulators of apoptosis does, however, offer novel therapeutic targets in both the prevention and treatment of atherosclerosis.