The formation of vascular lumens by endothelial cells is a critical step in the angiogenic process that occurs during invasion and growth of the incipient vascular sprout. Once a lumen is established, capillaries are rapidly exposed to the physical forces associated with the flow of blood which, together with genetic information, regulate the ultimate size of inner vessel diameter. Here we review the recent literature on vascular lumen formation and compare it to lumen formation in other epithelial systems. We also discuss the regulation of lumen diameter after vascular morphogenesis has been completed.