The role of tumor stroma in progression to malignancy has become the subject of intense experimental and clinical interest. The stromal compartment of organs is composed of all the non-epithelial cell types and maintains the proper architecture and nutrient levels required for epithelial and, ultimately, organ function. The composition of the reactive stroma surrounding tumors is vastly different from normal stromal tissue. Stromal phenotype can be correlated with, and predictive of, disease recurrence. In addition, the stroma is now seen as a legitimate target for therapeutic intervention. Although much has been learned about the role of the stromal compartment in development and disease in recent years, a number of key questions remain. Here we review how some of these questions are beginning to be addressed using new models of stromal-epithelial interaction.