Apoptosis is a mode of cell death in which intrinsic cellular mechanisms participate in the demise of the cell. The modulation of endothelial apoptosis may play a role in atherosclerosis, angiogenesis, vascular remodeling and other pathophysiological states. Control of cell death is mediated by the state of activation of a death pathway as well as by the levels of anti apoptotic proteins. The final common pathway of many, if not all, triggers of apoptosis involves activation of cysteine proteases. The Bcl 2 family, in contrast, appears to play a major role in protection against apoptosis. The role of these mechanisms in modulating endothelial cell apoptosis under various conditions is discussed.