Vascular inflammation, involving the recruitment, adhesion and infiltration of monocytes to the sub-endothelial space, is a critical early event in the development of atherosclerosis. The renin angiotensin system plays an important role in inflammation via activation of the angiotensin type I receptor (AT1R), which induces pro-inflammatory effects. The angiotensin II type 2 receptor (AT2R) counter-regulates the effects of the AT1R, including AT1R-mediated pro-inflammatory cytokine expression. We investigated the anti-inflammatory effects of AT2R stimulation in vascular inflammation by examining leukocyte to endothelial adhesion. We quantified the effect of AT2R stimulation (Compound 21: C21, 100μM) on TNFα (10ng/mL)-induced monocyte adhesion to cultured human umbilical vascular endothelial cells in vitro. AT2R stimulation attenuated TNFα-induced monocyte adhesion (unstimulated: 8±4% of TNFα: 100%, C21+TNFα: 59±12% of TNFα-induced adhesion). Adhesion of monocytes to the endothelial monolayer following incubation with TNFα+C21+AT2R antagonism (PD 123319, 10μM) was not different to TNFα-induced monocyte adhesion (93±5% of TNFα); demonstrating that the anti-inflammatory effects of C21 are mediated by the AT2R. Furthermore, C21 treatment attenuated TNFα-induced upregulation of adhesion molecules ICAM-1 and E-selectin and abolished TNFα-induced ROS production (unstimulated: 2±2, TNFα: 55±16, TNFα+C21: -3±5 dihydroethidium fluorescence intensity units). We quantified TNFα-induced leukocyte adhesion in intact mouse thoracic aorta ex vivo in real time in the presence and absence of AT2R activation. Consistent with our in vitro findings, we observed that direct AT2R activation (C21, 10μM) abolished TNFα-induced leukocyte adhesion (TNFα: 30±4, vs TNFα+C21: 11±4 adhered leukocytes/field of view (FOV), P<0.01) an effect which was abolished by co-incubation with PD 123319 (10μM: 31±5 adhered leukocytes/FOV). This study provides the first functional evidence that direct AT2R stimulation prevents TNFα-induced leukocyte adhesion, ICAM-1 and E-selectin expression and ROS production revealing the anti-inflammatory and therapeutic potential of the AT2R in the treatment of inflammation-induced cardiovascular disease.