Within the last 15 years, at least eight different G protein-coupled nucleotide receptors, i.e., P2Y receptors, have been characterized by molecular means. While ionotropic P2X receptors are mainly involved in fast synaptic neurotransmission, P2Y receptors rather mediate slower neuromodulatory effects. This P2Y receptor-dependent neuromodulation relies on changes in synaptic transmission via either pre- or postsynaptic sites of action. At both sites, the regulation of voltage-gated or transmitter-gated ion channels via G protein-linked signaling cascades has been identified as the predominant underlying mechanisms. In addition, neuronal P2Y receptors have been found to be involved in neurotoxic and neurotrophic effects of extracellular adenosine 5-triphosphate. This review provides an overview of the most prominent actions mediated by neuronal P2Y receptors and describes the signaling cascades involved.