Research conducted in recent years has significantly transformed our understanding of the role of the vascular endothelium in maintaining the overall homeostasis of the body. It has been revealed that the endothelium is responsible for synthesizing a wide range of biologically active substances that play a key role in numerous processes both in health and disease - such as hemodynamics, hemostasis, immunological responses, and regenerative processes. This extensive endocrine activity has led to the endothelium being sometimes referred to as an "endocrine tree." The functioning of the endothelium depends on its functional condition, which is shaped by the signals it receives. Endothelial dysfunction understood as an impairment of the vasodilatory, antithrombotic, and anti-inflammatory properties of the cells lining the vessels, is closely linked to cardiovascular diseases - the leading cause of death worldwide. It is considered a key stage in the development of atherosclerosis and one of the major risk factors for hypertension, diabetes mellitus, and cardiovascular incidents. The aim of this paper is to gather and present information that will allow for a better understanding of the structure and significance of this majestic organ in human physiology.