Vascular dysfunction underlies the pathophysiology of a wide range of diseases, including atherosclerosis, diabetes and arthritis. Angiogenic function is progressively impaired with increasing age and, therefore, has been linked to the increased risk of many of these diseases among older people. Elucidating the cellular and molecular angiogenic pathways that become dysregulated with age will lead to the identification of novel targets for the restoration of vascular repair mechanisms in the older population. This review examines the regulation of postnatal angiogenesis in vascular disease, the changes observed in ageing and highlights potential therapeutic targets, including endothelial progenitor cell-based strategies for the promotion of angiogenic pathways that are impaired with age.