Numerous studies have revealed the significant action of airway epithelium as a nonspecific defence mechanism in airways. In addition, epithelial cells release biologically active agents, which modulate airway tone. Importantly, airway epithelium function is influenced by physiological parameters, including the release of endogenous factors, age, gender, load, and bronchi size. The primary goal of this review is to summarize knowledge concerning the effect of the aforementioned parameters on the modulatory role of airway epithelium on airway smooth muscle responsiveness. These effects may be implicated in the pathophysiology of airway diseases like asthma and Chronic Obstructive Pulmonary Disease (COPD).