The in vitro construction of tissue-engineered small diameter (<6mm) blood vessels with sufficient strength and mechanical compliance has evaded researchers. We hypothesize that the high spatial organization of the medial layer of vascular smooth muscle cells (VSMCs) and their surrounding matrix provides high burst strength, compliance, and stability. We investigated the effect of microfabricated polydimethylsiloxane (PDMS) scaffolds with various groove widths on VSMC organization. We found that the presence of these grooved topographical cues significantly enhanced VSMC aspect ratio, alignment, and oriented remodeling of the underlying extracellular matrix. This study suggests that topographical patterning of tissue scaffolds can influence cellular and matrix spatial organization and could provide a framework for achieving the required organization and physical properties for blood vessels.