Airway smooth muscle contributes to changes in airway caliber not only through the variations in its tone but also through its contribution to thickness of the airway wall. Until recently, most attention was paid to the agents that altered airway smooth muscle tone, their receptors, the signal transduction pathways they activated, and the mechanisms of contraction and relaxation themselves. Lately, the regulation of smooth muscle proliferation has received increasing attention, and, most recently, the possible role of smooth muscle as a source of inflammatory mediators has been recognized. Airway smooth muscle cells are now seen as playing an important interactive role with inflammatory and structural cells in the response to injury and repair of the airways.