The growth and survival of many cell types requires integrin-mediated adhesion to the extracellular matrix (ECM). Physiologically, the prerequisite of cell-ECM adhesion interaction for cell cycle progression and cell survival is likely to be important in tissue morphology and regression as a mechanism to regulate tissue architecture and cell number. Pathologically, anchorage-dependent survival may limit tumor invasion and metastasis. Endothelial cells are anchorage-dependent cells, and many ECM molecules interacting with different classes of integrins promote their survival. It has became clear, however, that during the angiogenesis process the alpha(v)beta(3) integrin plays a fundamental role in maintaining endothelial cell viability. The downstream signals regulating this process are becoming clarified, and new functions are described for molecules involved in apparently distant systems.