Interspersed between cardiac myocytes, cardiac fibroblasts serve mainly as a structural support during ventricular wall thickening from embryogenesis until adulthood. Cardiac fibroblasts, however, may also serve as a source of mitogens, extracellular matrix proteins, cytokines, and growth factors that could affect the phenotype of the cardiac myocyte. The crosstalk between cardiac fibroblasts and myocytes is important during cardiac development and remodeling in response to injury. The cell-to-cell communication involves paracrine signals (cytokines and growth factors), direct interactions (connexins and cadherins) as well as indirect interactions (integrin signaling through the extracellular matrix). In this review, known cardiac fibroblast-cardiac myocyte signaling pathways are briefly examined and their effect on the heart during disease progression is discussed. Furthermore, speculations are made regarding the possibility that vascular endothelial growth factor B can serve as an important signaling molecule between cardiac fibroblasts and cardiac myocytes and could promote cardiac function in compromised hearts.