Vascular endothelial growth factor (VEGF) deletion in adult mouse muscle fibers contributes to impaired contractile and muscular adaptations to a hypertrophic stimulus suggesting a critical role in adult muscle growth. This review explores the hypothesis that VEGF is essential for adult muscle growth by impacting inflammatory processes, satellite-endothelial cell interactions, and contractile protein accumulation by functioning within known hypertrophic signaling pathways including insulin-like growth factor-1 (IGF-1-Akt) and Wnt-ß-catenin.