SummaryEmbryo-endometrium cross-talk represents the main limiting factor for a good implantation and pregnancy. At the time of implantation the interaction between blastocyst and endometrium, mediated by sex steroids hormones, immune cells and related soluble factors, induces significant modification in the superficial profile of extracellular matrix (ECM) proteins in both endometrium and blastocyst. More recently, it has been shown that also periostin (POSTN), a secreted ECM protein and a key element in metastatic processes plays an important role in the regulation of the embryo-endometrium cross-talk. It was observed that serum levels and tissue expression of POSTN may predict endometrial receptivity and pregnancy outcome implantation. Furthermore, ongoing data show a relationship between follicular fluid POSTN concentrations and embryo quality. Although a clinical validation it's required, preliminary results showed that, besides to the morphological, morphokinetic and genetic criteria, POSTN could be an easy non invasive biomarker to evaluate blastocyst quality and chance to obtain an adequate implantation. In this review we describe the main mechanisms by which POSTN may play its role in the regulation of embryo endometrium cross-talk.