After DNA damage, cells must decide between different fates including growth arrest, DNA repair, and apoptosis. Both p53 and E2F1 are transcription factors involved in the decision process. However, the mechanism for cross-talk between the p53 and E2F1 pathways still remains unclear. Here, we proposed a four-module kinetic model of the decision process and explored the interplay between these two pathways in response to ionizing radiation via computer simulation. In our model the levels of p53 and E2F1 separately exhibit pulsatile and switching behaviors. Upon DNA damage, p53 is first activated, whereas E2F1 is inactivated, leading to cell cycle arrest in the G 1 phase. We found that the ultimate decision between cell life and death is determined by the number of p53 pulses depending on the extent of DNA damage. For repairable DNA damage, the cell can survive and reenter the S phase because of the activation of E2F1 and inactivation of p53. For irreparable DNA damage, growth arrest is overcome by growth factors, and activated p53 and E2F1 cooperate to initiate apoptosis. We showed that E2F1 promotes apoptosis by up-regulating the proapoptotic cofactors of p53 and procaspases. It was also revealed that deregulated E2F1 by oncogene activation can make cells sensitive to DNA damage even in low serum medium. Our model consistently recapitulates the experimental observations of the intricate relationship between p53 and E2F1 in the DNA damage response. This work underscores the significance of E2F1 in p53-mediated cell fate decision and may provide clues to cancer therapy.The tumor suppressor p53 has a crucial role in preventing tumorigenesis (1). Upon various stresses, p53 is stabilized and activated to function primarily as a transcription factor, regulating the expression of a large number of genes involved in cell cycle arrest, DNA repair, or apoptosis (2). Thus, p53 is at the hub of numerous signaling pathways triggered by various stresses. Previously, it was proposed that cell fate after DNA damage is governed by p53 levels, i.e. a low level of p53 leads to transient growth arrest and cell survival, whereas a high level promotes irreversible apoptosis (3). Recently, it has been reported that p53 levels can exhibit oscillations in response to DNA damage induced by ionizing radiation (IR) (4, 5). Whereas damped oscillations of p53 levels were observed at the population level (4), a series of undamped pulses was observed at the single-cell level (5). In such a digital mode, it is the number of p53 pulses rather than their amplitudes and duration that is related to the extent of DNA damage and determines cell fate (5). p53 pulses can be generated by negative feedback loops with time delay (6 -8) or coupled positive and negative feedback loops (9, 10).How stressed cells exploit p53 pulses to translate various stresses into different cellular outcomes is not completely understood. Several studies have explored the functional roles of p53 pulses in response to DNA damage. Tyson and co-workers (10) classified active p5...