Calcium ions (Ca 2+ ) are prominent cell signaling effectors that regulate a wide variety of cellular processes. Among the different players in Ca 2+ homeostasis, primary active Ca 2+ transporters are responsible for keeping low basal Ca 2+ levels in the cytosol while establishing steep Ca 2+ gradients across intracellular membranes or the plasma membrane. This review summarizes our current knowledge on the three types of primary active Ca 2+ -ATPases: the sarco(endo)plasmic reticulum Ca 2+ -ATPase (SERCA) pumps, the secretory pathway Ca 2+ -ATPase (SPCA) isoforms, and the plasma membrane Ca 2+ -ATPase (PMCA) Ca 2+ -transporters. We first discuss the Ca 2+ transport mechanism of SERCA1a, which serves as a reference to describe the Ca 2+ transport of other Ca 2+ pumps. We further highlight the common and unique features of each isoform and review their structure-function relationship, expression pattern, regulatory mechanisms, and specific physiological roles. Finally, we discuss the increasing genetic and in vivo evidence that links the dysfunction of specific Ca 2+ -ATPase isoforms to a broad range of human pathologies, and highlight emerging therapeutic strategies that target Ca 2+ pumps.