The extracellular matrix (ECM) is a dynamic structure present in all tissues and is essential for life. It undergoes controlled remodelling, involving changes in composition, structure, and stiffness, which regulate tissue homeostasis and organ development. The ECM interacts with cells to control functions such as proliferation, migration, and differentiation. Dysregulation of the ECM contributes to diseases like fibrosis and cancer. The ECM is composed of around 300 proteins, including collagens, proteoglycans, and glycoproteins, and is divided into two main types: the interstitial connective tissue matrix and the basement membrane. ECM remodelling is crucial for organ development and disease progression, and involves enzymes such as matrix metalloproteinases (MMPs), ADAMs, and ADAMTS. These enzymes degrade and cleave ECM components, generating fragments with biological functions. ECM remodelling also releases growth factors, which influence cell behaviour and organ development. Aberrant ECM remodelling leads to diseases such as fibrosis and cancer, and targeting the ECM, its enzymes, and receptors offers therapeutic potential. The ECM also plays a role in angiogenesis, immune cell migration, and cancer progression. Understanding ECM dynamics is crucial for developing new therapies for diseases.The extracellular matrix (ECM) is a dynamic structure present in all tissues and is essential for life. It undergoes controlled remodelling, involving changes in composition, structure, and stiffness, which regulate tissue homeostasis and organ development. The ECM interacts with cells to control functions such as proliferation, migration, and differentiation. Dysregulation of the ECM contributes to diseases like fibrosis and cancer. The ECM is composed of around 300 proteins, including collagens, proteoglycans, and glycoproteins, and is divided into two main types: the interstitial connective tissue matrix and the basement membrane. ECM remodelling is crucial for organ development and disease progression, and involves enzymes such as matrix metalloproteinases (MMPs), ADAMs, and ADAMTS. These enzymes degrade and cleave ECM components, generating fragments with biological functions. ECM remodelling also releases growth factors, which influence cell behaviour and organ development. Aberrant ECM remodelling leads to diseases such as fibrosis and cancer, and targeting the ECM, its enzymes, and receptors offers therapeutic potential. The ECM also plays a role in angiogenesis, immune cell migration, and cancer progression. Understanding ECM dynamics is crucial for developing new therapies for diseases.