Obesity increases the risk of hormone receptor-positive breast cancer in postmenopausal women. Levels of aromatase, the ratelimiting enzyme in estrogen biosynthesis, are increased in the breast tissue of obese women. Both prostaglandin E 2 (PGE 2 ) and hypoxia-inducible factor 1␣ (HIF-1␣) contribute to the induction of aromatase in adipose stromal cells (ASCs). Sirtuin 1 (SIRT1) binds, deacetylates, and thereby inactivates HIF-1␣. Here, we sought to determine whether SIRT1 also plays a role in regulating aromatase expression. We demonstrate that reduced SIRT1 levels are associated with elevated levels of acetyl-HIF-1␣, HIF-1␣, and aromatase in breast tissue of obese compared with lean women. To determine whether these changes were functionally linked, ASCs were utilized. In ASCs, treatment with PGE 2 , which is increased in obese individuals, down-regulated SIRT1 levels, leading to elevated acetyl-HIF-1␣ and HIF-1␣ levels and enhanced aromatase gene transcription. Chemical SIRT1 activators (SIRT1720 and resveratrol) suppressed the PGE 2 -mediated induction of acetyl-HIF-1␣, HIF-1␣, and aromatase. Silencing of p300/CBP-associated factor (PCAF), which acetylates HIF-1␣, blocked PGE 2 -mediated increases in acetyl-HIF-1␣, HIF-1␣, and aromatase. SIRT1 overexpression or PCAF silencing inhibited the interaction between HIF-1␣ and p300, a coactivator of aromatase expression, and suppressed p300 binding to the aromatase promoter. PGE 2 acted via prostaglandin E2 receptor 2 (EP 2 ) and EP 4 to induce activating transcription factor 3 (ATF3), a repressive transcription factor, which bound to a CREB site within the SIRT1 promoter and reduced SIRT1 levels. These findings suggest that reduced SIRT1mediated deacetylation of HIF-1␣ contributes to the elevated levels of aromatase in breast tissues of obese women. . 3 The abbreviations used are: ER, estrogen receptor; CRE, cyclic AMP-response element; CREB, CRE-binding protein; HIF-1␣, hypoxia inducible factor-1␣; PGE 2 , prostaglandin E 2 ; ASC, adipose stromal cell; SIRT1, sirtuin 1; BMI, body mass index; PCAF, p300/CBP-associated factor; PKA, protein kinase A; ATF3, activating transcription factor 3; EP, prostaglandin E2 receptor; HRE, hypoxia-responsive element; FPKM, fragments per kilobase per million.