Calcium (Ca²⁺) plays a central role in excitation, contraction, transcription, and proliferation of vascular smooth muscle cells (VSMs). Precise regulation of intracellular Ca²⁺ concentration ([Ca²⁺]_i) is crucial for proper physiological VSM function. Studies over the last several decades have revealed that VSMs express a variety of Ca²⁺-permeable channels that orchestrate a dynamic, yet finely tuned regulation of [Ca²⁺]_i. In this review, we discuss the major Ca²⁺-permeable channels expressed in VSM and their contribution to vascular physiology and pathology.