Vascular calcification is clinically important in the development of cardiovascular disease. It has been suggested that apoptosis and chondro/osteogenic differentiation of vascular smooth muscle cells (VSMC) play important roles in the initiation and progression of vascular calcification. During the process of vascular calcification, growth arrest-specific gene 6 (Gas6) mediated-survival pathway is downregulated in VSMC, leading to apoptosis. Chondro/osteogenic differentiation regulated by transcription factors such as core binding factor alpha1 (Cbfa1) or msh homeo box homolog 2 (Msx2), promotes VSMC calcification. It is clear that vascular calcification is an active process regulated by various factors including Gas6, Cbfa1, or Msx2.