Apoptosis occurs during normal development of an organism but also plays an important role under pathophysiological conditions. Nitric oxide (NO) exhibits a double-edged role in apoptosis induction. Both pro- and antiapoptotic effects of NO have been demonstrated. The proapoptotic effects appear to be linked to pathophysiological conditions, where high concentrations of NO are produced by the inducible nitric oxide synthase, especially in macrophages. In contrast, NO also prevents apoptosis induction by various stimuli. The antiapoptotic effects thereby were mainly mediated by low amounts of NO or stimulation of the constitutive, endothelial nitric oxide synthase. The present review characterizes the apoptotic cell death program and aims to give a detailed insight into the function of NO in affecting apoptotic processes in biological systems, with special regards to the immune and cardiovascular systems.