Recent evidence has highlighted the role of endothelial-to-mesenchymal transition (EndoMT) in the onset and progression of a number of human pathologies. EndoMT involves the loss of an endothelial signature to generate unspecialized mesenchymal-like cells, susceptible to being re-differentiated into mesodermal cell types, including osteoblasts, chondrocytes, and adipocytes. Therefore, modulation of the molecular pathways controlling EndoMT can be considered as a therapeutic approach for particular human diseases. In addition, EndoMT may be harnessed for tissue engineering by producing multipotent mesenchymal cells able to differentiate into mutiple cell types. Copyright © 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.