Alpha4 integrins (alpha4beta1 and alpha4beta7) have a restricted distribution pattern and are critical for the development and diseases of the cardiovascular system. alpha4 integrins support unique biological properties such as promoting cell migration and inhibiting cell spreading and focal adhesion formation. We have found that the alpha4 integrin subunit directly and tightly binds to a signaling adapter molecule, paxillin, and disruption of the alpha4-paxillin interaction interferes with many of alpha4-dependent biological functions. Consequently, the interaction of alpha4 integrins with paxillin may play an important role in regulating alpha4-mediated functions. This review focuses on what we have known about the alpha4-paxillin interaction and discusses the possible mechanism of regulation for this interaction.