Clinical treatment of diabetic patients by islet transplantation faces various complications. At present, in vitro expansion of islets occurs at the cost of their essential features, which are insulin production and release. However, the recent discovery of blood vessel/beta-cell interactions as an important aspect of insulin transcription, secretion, and proliferation might point us to ways of how this problem could be overcome. The correct function of beta-cells depends on the presence of a basement membrane, a specialized extracellular matrix located around the blood vessel wall in mouse and human pancreatic islets. In this chapter, we summarize how the vascular basement membrane influences insulin transcription, insulin secretion, and beta-cell proliferation. In addition, a brief overview about basement membrane components and their interactions with cell surface receptors is given.