Agonist–receptor interactions regulate airway smooth muscle tone through activation of guanine nucleotide binding proteins (G proteins), which are coupled to second messenger pathways that mediate changes in the tissue's contractile state. With respect to airway smooth muscle (ASM) contraction, receptor activation elicits phosphatidylinositol turnover that results in the formation of the second messengers, 1,2,-diacylglyserol, which activates protein kinase C (PKC), and inositol 1,4,5,-trisphosphate (Ins[1,4,5]P3), which binds to its intracellular receptor to mobilize intracellular calcium (Ca2 +). Both the mobilization of Ca2 + and activation PKC play critical roles in initiating and acutely modulating the intensity and duration of the ASM contraction response. In contrast, bronchodilator agonist-mediated receptor activation is typically coupled to an enhanced accumulation of the second messenger, adenosine 3 ′,5 ′ -cyclic monophosphate (cAMP) which, through activation of cAMP-dependent protein kinase, induces the phosphorylation of specific proteins, leading to ASM relaxation. For activation of both of these functionally distinct signal transduction pathways, the agonist–receptor complexes interact with specific G proteins, which in turn modulate the enzymes regulating the production of their respective second messengers. Perturbations in Ins(1,4,5)P3 accumulation, its metabolism and intracellular binding may underlie changes in ASM contractility. Comparably, changes in ASM relaxation responsiveness, secondary to perturbations in cAMP accumulation, may be due to altered receptor/G protein modulation of adenylate cyclase activity, as well as to altered binding of Ins(1,4,5)P3 to its Ca2 +-mobilizing intracellular receptor. This review begins with an overview of the structural and functional characteristics of G protein–linked receptors, followed by descriptions of the role of G proteins, their transmembrane signaling processes, and mechanisms regulating second messenger–coupled ASM contraction and relaxation, and concludes with new information underscoring the important roles of altered receptor/G protein–coupled expression and regulatory interactions between signaling pathways in modulating second-messenger accumulation and action in the “pro-asthmatic” sensitized airway smooth muscle. Hakonarson H, Grunstein MM. Regulation of second messengers associated with airway smooth muscle contraction and relaxation.