The past 20 years have witnessed enormous progress in our understanding of the biology of vascular endothelium and its role in cardiovascular disease. Stemming from the seminal observations of Furchgott, the concept of a continuous regulation of vascular tone by normal endothelium and alterations of such control in disease states has become one of the most enlightening concepts of cardiovascular research. This review covers a few updates on the topic, illustrating selective areas of recent progress in our understanding of endothelial function in the control of leucocyte adhesion, atherogenesis and vascular tone, as well as the alterations that cause and accompany vascular disease.