Core tip: This is a comprehensive review regarding the role and mechanism of the CD38/Cyclic adenosine diphosphate ribose (cADPR)/Ca 2+ signaling pathway in various cellular processes. We introduce the structure and function of cADPR, together with its production and degradation pathways. We also describe CD38, the main enzyme that is responsible for synthesis of cADPR, through its structure and topology. Finally, we summarize the functions of the CD38/cADPR/Ca 2+ signaling pathway under both physiological and pathological conditions. Wei W, Graeff R, Yue J. Roles and mechanisms of the CD38/ cyclic adenosine diphosphate ribose/Ca 2+ signaling pathway.