The mammalian extracellular matrix (ECM) is a complex network of collagens, proteoglycans, glycoproteins, polysaccharides and other secreted proteins that plays fundamental structural and functional roles. In addition to its key function as an extracellular space-filling scaffold, the ECM is also implicated in the formation of important cell-cell and cell-ECM (i.e. juxtacrine) interactions that subsequently provide key regulatory signals that influence cellular proliferation and viability, differentiation, specialization and gene expression. Regulated turnover of the ECM, a process largely mediated by the tightly controlled matrix metalloprotease (MMP) enzyme family, is critical to a number of physiological processes involved in growth and development while aberrant turnover of matrix components is associated with congenital and metabolic diseases. The following review will focus on the transcriptional aspects of MMP gene expression, particularly in diseased states.