Pericytes are mural cells embedded in the basement membrane of blood vessels, playing a critical role in the neurovascular unit (NVU) by regulating functions such as blood-brain barrier (BBB) integrity, angiogenesis, and neuroinflammation. They interact with endothelial cells, astrocytes, and neurons, and their dysfunction is linked to various neurological disorders, including Alzheimer's disease (AD), brain tumors, and cerebrovascular diseases. Key signaling pathways, such as PDGF-BB/PDGFRβ, TGF-β/TGFβR2, Notch, VEGF-A/VEGFR2, and Ang/Tie2, regulate pericyte functions and are involved in disease pathogenesis. The PDGF-BB/PDGFRβ pathway is crucial for pericyte survival, proliferation, and BBB maintenance, while TGF-β signaling influences pericyte differentiation and vascular stability. Notch signaling modulates angiogenesis and vascular remodeling, and VEGF-A/VEGFR2 signaling promotes angiogenesis and vascular permeability. The Ang/Tie2 pathway is essential for vascular stability and BBB function. Additionally, the MFSD2A pathway facilitates fatty acid transport across the BBB, and the ephrin/Eph pathway regulates pericyte-endothelial interactions. Pericyte-astrocyte interactions, such as the CypA-NFκB-MMP-9 pathway, contribute to BBB breakdown and neuroinflammation. Neurotrophic factors and neurotransmitters also influence pericyte function and vascular dynamics. Understanding these pathways is essential for developing therapeutic strategies targeting pericyte dysfunction in neurological disorders.Pericytes are mural cells embedded in the basement membrane of blood vessels, playing a critical role in the neurovascular unit (NVU) by regulating functions such as blood-brain barrier (BBB) integrity, angiogenesis, and neuroinflammation. They interact with endothelial cells, astrocytes, and neurons, and their dysfunction is linked to various neurological disorders, including Alzheimer's disease (AD), brain tumors, and cerebrovascular diseases. Key signaling pathways, such as PDGF-BB/PDGFRβ, TGF-β/TGFβR2, Notch, VEGF-A/VEGFR2, and Ang/Tie2, regulate pericyte functions and are involved in disease pathogenesis. The PDGF-BB/PDGFRβ pathway is crucial for pericyte survival, proliferation, and BBB maintenance, while TGF-β signaling influences pericyte differentiation and vascular stability. Notch signaling modulates angiogenesis and vascular remodeling, and VEGF-A/VEGFR2 signaling promotes angiogenesis and vascular permeability. The Ang/Tie2 pathway is essential for vascular stability and BBB function. Additionally, the MFSD2A pathway facilitates fatty acid transport across the BBB, and the ephrin/Eph pathway regulates pericyte-endothelial interactions. Pericyte-astrocyte interactions, such as the CypA-NFκB-MMP-9 pathway, contribute to BBB breakdown and neuroinflammation. Neurotrophic factors and neurotransmitters also influence pericyte function and vascular dynamics. Understanding these pathways is essential for developing therapeutic strategies targeting pericyte dysfunction in neurological disorders.