Abstract-Vascular remodeling stands for structural changes of the vessel wall in response to various noxious stimuli, which results in reorganization of the vessel wall architecture. Luminal narrowing because of neointima formation and constrictive remodeling leading to hypoperfusion is the most relevant clinical effect. Smooth muscle cell (SMC) accumulation, inflammatory cell recruitment, and endothelial regeneration are the critical parts in obstructive vascular remodeling. Chemokines and chemokine receptors have a great impact on initiating and progressing neointimal formation by controlling each step of the remodeling process. SDF-1␣ regulates vascular repair by CXCR4-dependent smooth muscle progenitor cell recruitment, which contributes to the maladaptive response to injury. The three distinct chemokine-chemokine receptor pairs MCP-1/CCR2, RANTES/CCR5, and Fractalkine/CX 3 CR1 direct lesional leukocyte infiltration. In addition MCP-1/CCR2 and Fractalkine/CX 3 CR1 increase neointimal SMC expansion. In contrast, KC/Gro-␣ supports endothelial recovery through CXCR2, which attenuates neointima formation. These findings highlight the importance to characterize specific functions of the chemokine network to enable therapeutic intervention. V ascular remodeling denotes morphological changes of the vessel wall in response to various noxious stimuli inducing reorganization of the vessel wall structure. This impacts the cross-sectional vessel diameter and the thickness of the arterial wall in every direction; however, luminal narrowing and resulting hypoperfusion are the most detrimental sequelae of vascular remodeling. Hemodynamic stress, mechanical injury, inflammation, or hypoxia are only some of the clinically met triggers for adaptive remodeling of the vessel wall, for instance after percutaneous interventions, heart transplantation, or vein grafting. 1 Morphologically, all three layers of the arterial wall are concurrently affected by neointimal hyperplasia, medial thickening, and adventitial fibrosis attributable to the interaction of leukocyte recruitment, smooth muscle cell (SMC) accumulation, and endothelial recovery. 2,3 Molecularly, chemokines play an everemerging role in vascular repair through guidance of circulating mononuclear cells to the injury site and activation of resident vascular cells. 4,5 Considering the cell-type specific expression of chemokine receptors and the substantial overlap in ligand-receptor specificity, an interactive network of chemokines and chemokine receptors emerges with enormous plasticity in different types of vascular injury. However, a growing number of chemokine-chemokine receptor pairs with confined effects in vascular diseases have been described. 6,7 To modulate the maladaptive response in arterial remodeling, it is essential to identify specific therapeutic targets in the chemokine network. The contribution of the chemokine system to arteriosclerotic diseases has been previously reviewed in-depth. 8 -10 This review focuses on most recent findings in regulation and f...