The tumor suppressor p53 plays a crucial role in cellular response to various stresses. Recent experiments have shown that p53 level exhibits a series of pulses after DNA damage caused by ionizing radiation (IR). However, how the p53 pulses govern cell survival and death remains unclear. Here, we develop an integrated model with four modules for the p53 network and explore the mechanism for cell fate decision based on the dynamics of the network. By numerical simulations, the following processes are characterized. First, DNA repair proteins bind to IR-induced double-strand breaks, forming complexes, which are then detected by ataxia telangiectasia mutated (ATM). Activated ATM initiates the p53 oscillator to produce pulses. Consequently, the target genes of p53 are selectively induced to control cell fate. We propose that p53 promotes the repair of minor DNA damage but suppresses the repair of severe damage. We demonstrate that cell fate is determined by the number of p53 pulses relying on the extent of DNA damage. At low damage levels, few p53 pulses evoke cell cycle arrest by inducing p21 and promote cell survival, whereas at high damage levels, sustained p53 pulses trigger apoptosis by inducing p53AIP1. We find that p53 can effectively maintain genomic integrity by regulating the efficiency and fidelity of DNA repair. We also show that stochasticity in the generation and repair of DNA damage leads to variability in cell fate. These findings are consistent with experimental observations and advance our understanding of the dynamics and functions of the p53 network.p53 network ͉ DNA repair ͉ apoptosis ͉ variability T he tumor suppressor protein p53 is a key mediator of cellular response to various stresses (1), and it performs its function primarily as a transcription factor, controlling the expression of a number of target genes (2). In response to DNA damage, the p53 signaling network is activated to induce cell cycle arrest, DNA repair, and apoptosis (1). Previously, it was proposed that p53 responds to DNA damage in an analog mode, i.e., a low level of p53 promotes cell survival by inducing cell cycle arrest and facilitating DNA repair, whereas a high level of p53 induces apoptosis to destroy irreparably damaged cells (1). Recently, damped oscillations of p53 level have been observed upon IR at the population level in several human cell lines and transgenic mice (3-6), with the amplitude of oscillations depending on the IR dose (5). More interestingly, pulses of p53 level were revealed in individual MCF7 cells, and the mean number of pulses, rather than the amplitude, was found to be related to the IR dose (7). This was suggested as a digital mode of p53 response (7). Later, it was further found that some MCF7 cells exhibit permanent p53 pulses whereas a few cells still show a finite number of p53 pulses during long-term observations (8). Such permanent oscillations may be related to the deficiency in DNA repair and apoptosis induction in those transformed cells (9-11). Moreover, the damped oscillations obse...