Mast cells are the principal initial effector cells in the modulation of allergic inflammation. They are now known to arise from CD34+ pluripotential stem cells, circulate through the blood as CD34+, Fc epsilon RI-, Kit+ committed but undifferentiated cells, and migrate into tissues where they mature in the presence of Kit-ligand (stem cell factor) and other locally produced cytokines. Mast cells undergo programmed cell death (apoptosis) when stem cell factor is not available. Mast cells adhere to specific connective tissue components such as fibronectin and laminin. This interaction localizes mast cells to specific sites while altering their biologic responsiveness. Mast cells, when activated through Fc epsilon RI, release and generate a wide variety of cytokines including IL-4 and IL-5. This information provides new insights on how allergic reactions may be modified by developing strategies to effect mast cell viability, survival and localization; and the production of inflammatory mediators.