Increasing evidence suggests that endothelial cell apoptosis might contribute to atherogenesis, plaque erosion and acute coronary syndromes. The present review article summarizes the current findings and discusses the potential role of endothelial cell apoptosis for coronary artery disease progression. Moreover, the signalling events that critically regulate endothelial cell apoptosis are discussed. The article focuses on the regulation of endothelial cell apoptosis by the redox balance, which is mainly determined by reactive oxygen species and nitric oxide. Moreover, the role of S-nitrosylation of protein targets for protection of endothelial cell apoptosis will be discussed.