The present study tests the hypothesis that vascular cells promote the survival of postganglionic sympathetic neurons in the absence of nerve growth factor (NGF). To test this hypothesis, neurons isolated from superior cervical ganglia of 2- to 4-day-old rat pups were grown in the absence of NGF and in the absence and presence of vascular smooth muscle cells (VSM). Neuronal survival was assessed as a function of time in culture. At all time points studied, VSM promoted the survival of the neurons. After 5 days in the absence of NGF, 7 ± 2% of neurons survived in the absence and 28 ± 7% survived in the presence of VSM. An endothelin receptor antagonist reduced neuronal survival in cocultures grown in the absence of NGF. These data indicate that VSM produce factors other than NGF that promote the survival of cultured postganglionic sympathetic neurons. The data also indicate that endothelin contributes to this effect and suggest that endothelin as well as other VSM-derived factors may play a role in the development of sympathetic innervation to the vasculature.