During angiogenesis, endothelial cells (ECs) from intact blood vessels quickly infiltrate avascular regions via vascular sprouting. This process is fundamental to many normal and pathological processes such as wound healing and tumor growth, but its initiation and control are poorly understood. Vascular endothelial cell growth factor (VEGF) can promote vessel dilation and angiogenic sprouting, but given the complex nature of vascular morphogenesis, additional signals are likely necessary to determine, for example, which vessel segments sprout, which dilate, and which remain quiescent. Fluid forces exerted by blood and plasma are prime candidates that might codirect these processes, but it is not known whether VEGF cooperates with mechanical fluid forces to mediate angiogenesis. Using a microfluidic tissue analog of angiogenic sprouting, we found that fluid shear stress, such as exerted by flowing blood, attenuates EC sprouting in a nitric oxide-dependent manner and that interstitial flow, such as produced by extravasating plasma, directs endothelial morphogenesis and sprout formation. Furthermore, positive VEGF gradients initiated sprouting but negative gradients inhibited sprouting, promoting instead sheet-like migration analogous to vessel dilation. These results suggest that ECs integrate signals from fluid forces and local VEGF gradients to achieve such varied goals as vessel dilation and sprouting.3D angiogenesis on a chip | collagen gel | structural remodeling | alternative to animal model | vessel analog A ngiogenesis, the expansion or extension of existing vasculature, is necessary to deliver oxygen and nutrients to ischemic or avascular regions in wounds and solid tumors (1), and a fundamental understanding of the determinants of angiogenesis would accelerate progress in the fields of regenerative medicine, tissue engineering, and oncology. Angiogenesis requires the coordinated growth and migration of endothelial cells (ECs): each EC residing in a vessel wall integrates local signals to determine whether it remains quiescent (2, 3), participates in dilation or contraction (1), undergoes morphogenesis to form an angiogenic sprout (4, 5), or intussusceptive involution (6). Implicit in these processes are endothelial proliferation during expansion of the vasculature and their loss during vessel contraction and pruning (7).Growth factors have pleiotropic effects on ECs and are undoubtedly key controllers of vascular morphogenesis. The best studied vascular morphogen, vascular endothelial growth factor (VEGF) (8), stimulates EC migration (9), proliferation (10), and matrix degradation (2). VEGF also controls vessel morphogenesis by inducing Delta-like ligand 4 (Dll4)-a membrane-bound ligand for the Notch family of receptors-at the advancing front of sprouts (11), thereby promoting the formation of specialized "tip cells," which extend protrusions or filopodia that sense growth factor concentrations to guide sprouts (4, 5). However, given the distinct phenotypes exhibited by ECs during sprouting, dilation, co...