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During the past decade the simple molecule nitric oxide (NO) has emerged as an important inter- and intracellular messenger regulating many biological functions such as vascular tone, platelet activation and neurotransmission. NO is also an important immunoregulatory molecule with cytostatic and cytotoxic properties [1,2]. The unravelling of the pathways and the role of NO in different cell systems has led to radical changes in the understanding of a wide variety of biological processes. Nowhere has this change been more apparent than in mammalian vascular biology. The present review focuses on NO and the vascular system, and discusses the pathophysiological implications of NO for human vascular disease states.