Although the essential role of cyclooxygenase (COX)-2 in fracture healing is known, the targeted genes and molecular pathways remain unclear. Using prostaglandin E2 receptor (EP)2 and EP4 agonists, we examined the effects of EP receptor activation in compensation for the lack of COX-2 during fracture healing. In a fracturehealing model, COX-2 ؊/؊ mice showed delayed initiation and impaired endochondral bone repair, accompanied by a severe angiogenesis deficiency. The EP4 agonist markedly improved the impaired healing in COX-2 ؊/؊ mice, as evidenced by restoration of bony callus formation on day 14, a near complete reversal of bone formation, and an approximately 70% improvement of angiogenesis in the COX-2 ؊/؊ callus. In comparison, the EP2 agonist only marginally enhanced bone formation in COX-2 ؊/؊ mice. To determine the differential roles of EP2 and EP4 receptors on COX-2-mediated fracture repair, the effects of selective EP agonists on chondrogenesis were examined in E11.5 longterm limb bud micromass cultures. Only the EP4 agonist significantly increased cartilage nodule formation similar to that observed during prostaglandin E2 treatment. The prostaglandin E2/EP4 agonist also stimulated MMP-9 expression in bone marrow stromal cell cultures. The EP4 agonist further restored the reduction of MMP-9 expression in the COX-2 ؊/؊ fracture callus. Taken together, our studies demonstrate that EP2 and EP4 have differential functions during endochondral bone repair. Activation of EP4, but not EP2 rescued impaired bone fracture healing in COX-2 ؊/؊ mice. Fracture healing is a complex process orchestrated by precise presentation of growth factors and cytokines that control activation, proliferation, and differentiation of the local mesenchymal stem/progenitor cells. Fracture healing begins with hematoma formation and an inflammatory response. The activated stem/progenitor cells proliferate and further differentiate into osteoblasts and chondrocytes. Endochondral bone formation takes place toward the most central avascular region of the callus. Chondrogenesis initiates directly adjacent to the surface of the cortical bone and is surrounded by less-differentiated mesenchymal progenitor cells. The subsequent expansion of the callus involves the conversion of the lingering mesenchymal progenitor cells into chondrocytes and further proliferation and differentiation of chondrocytes into a calcified cartilage template that permits vascular invasion and bone formation. Areas of intramembranous bone formation flank the area of endochondral ossification, particularly along the bone surface furthest from the central fracture site where the blood supply is typically better preserved. The coordinated endochondral and intramembranous bone formation pathways eventually result in a bridging mineralized callus that re-establishes the integrity of the skeletal element.