The abnormal proliferation of vascular smooth muscle cells (VSMCs) in arterial walls is an important pathogenetic factor of vascular disorders such as atherosclerosis and restenosis after angioplasty. Epothilone B, a novel potential antitumor compound, has a potent effect on preventing postangioplasty restenosis. Therefore, we established an in vivo rat carotid injury model and examined the potential effects of epothilone B on cardiovascular disease. We found that epothilone B potently prevented neointimal formation and in vivo VSMCs proliferation. In addition, we also showed that epothilone B significantly inhibited 5% fetal bovine serum (FBS)-and 50 ng/ml plateletderived growth factor (PDGF)-BB-induced proliferation and cell cycle progression in rat aortic VSMCs. Furthermore, FBS and PDGF-BB induced the activations of extracellular signal-regulated kinases 1 and 2, Akt, phospholipase C ␥ 1, and PDGFreceptor  chain tyrosine kinase were not changed by epothilone B. However, epothilone B treatment caused a significant decrease in the level of cyclin-dependent protein kinase (CDK) 2, whereas it caused no change in the levels of cyclin E and down-regulated the phosphorylation of retinoblastoma, which plays a critical role in cell cycle regulation. Furthermore, levels of p27, an inhibitor of cyclin E/CDK2 complex, were significantly increased in VSMCs treated with epothilone B, indicating that this might be a major molecular mechanism for the inhibitory effects of epothilone B on the proliferation and cell cycle of VSMCs. These findings suggest that epothilone B can inhibit neointimal formation via the cell cycle arrest by the regulation of the cell cycle-related proteins in VSMCs.Proliferation and migration of vascular smooth muscle cells (VSMCs) play a pivotal role in the development of restenosis and in the progression of atherosclerosis (Ross, 1993). Arterial injury results in the migration of VSMCs into the intimal layer of the arterial wall, where they proliferate and synthesize extracellular matrix components. Many growth factors induce the proliferation of VSMCs in vitro and in vivo. Among them, platelet-derived growth factor (PDGF) and basic fibroblast growth factor are important regulators of VSMC behavior through their well defined actions as potent chemoattractants and strong mitogens. Administration of these growth factors enhances intimal thickening after angioplasty in rat, whereas injection of antibodies or use of antisense technology to block signal transduction by either of these growth factors potently inhibits postinjury intimal hyperplasia in rat and restenosis in pig, suggesting that VSMC growth plays an important role in the pathogenesis of these models.Arterial injury during percutaneous transluminal coronary angioplasty induces multiple signaling pathways that activate VSMC migration and proliferation. Immediately after injury, VSMCs leave their quiescent state and enter the cell