In recent years, the type 1 insulin-like growth factor receptor (IGF-IR) has emerged as a receptor that plays a very important role in the growth of cells, both in vivo and in vitro. The ability of the IGF-IR to induce mitogenesis and to promote survival of cells against a variety of apoptotic agents is well documented. Somewhat less known are other functions of the IGF-IR, like its ability to induce differentiation, to regulate cell size and to affect the organization of the cytoskeleton of cells. This review will focus on these lesser known functions of the IGF-IR. At the same time, we will emphasize how the IGF-IR can send contradictory signals, which depend on different domains of the receptor and the availability of downstream transducing molecules.