Adrenomedullin (ADM) functions as a survival factor against hypoxic cell death. However, molecular mechanisms underlying the cell survival pathway remain largely unknown. In this report, we showed that ADM suppressed reactive oxygen species (ROS) increase by inhibiting reduction of glutathione (GSH) level in hypoxia/reoxygenation (H/R) injury, and increased the activities of glutathione peroxidase and reductase. In addition, ADM maintained total and active reduced thioredoxin (Trx) levels against H/R. We also found that ADM blocked nuclear translocation of Trx induced by H/R. The results of the present study show that ADM regulates cellular ROS levels via the GSH and Trx system.