The leading causes of blindness are retinal and choroidal diseases manifesting abnormal vessel permeability and growth. Scientists have sought to understand the mechanisms underlying these pathologic conditions with the hope of developing directed and effective pharmacologic therapies. Research has yielded important new mechanistic data, making possible the development of new drugs. One of the most important targets to have emerged is a secreted protein named vascular endothelial growth factor. This review will summarize the current state of our knowledge regarding this growth factor and outline some important questions that remain to be answered.