We have shown earlier a requirement for Ca 2+ and calmodulin (CaM) in the H 2 O 2 -induced activation of extracellular signal-regulated kinases 1 and 2 (ERK1/2) and protein kinase B (PKB), key mediators of growth-promoting, proliferative, and hypertrophic responses in vascular smooth muscle cells (VSMC). Because the effect of CaM is mediated through CaM-dependent protein kinase II (CaMKII), we have investigated here the potential role of CaMKII in H 2 O 2 -induced ERK1/2 and PKB phosphorylation by using pharmacological inhibitors of CaM and CaMKII, a CaMKII inhibitor peptide, and siRNA knockdown strategies for CaMKIIα. Calmidazolium and W-7, antagonists of CaM, as well as KN-93, a specific inhibitor of CaMKII, attenuated H 2 O 2 -induced responses of ERK1/2 and PKB phosphorylation in a dose-dependent fashion. Similar to H 2 O 2 , calmidazolium and KN-93 also exhibited an inhibitory effect on glucose/glucose oxidase-induced phosphorylation of ERK1/2 and PKB in these cells. Transfection of VSMC with CaMKII autoinhibitory peptide corresponding to the autoinhibitory domain (aa 281–309) of CaMKII and with siRNA of CaMKIIα attenuated the H 2 O 2 -induced phosphorylation of ERK1/2 and PKB. In addition, calmidazolium and KN-93 blocked H 2 O 2 -induced Pyk2 and insulin-like growth factor-1 receptor (IGF-1R) phosphorylation. Moreover, treatment of VSMC with CaMKIIα siRNA abolished the H 2 O 2 -induced IGF-1R phosphorylation. H 2 O 2 treatment also induced Thr 286 phosphorylation of CaMKII, which was inhibited by both calmidazolium and KN-93. These results demonstrate that CaMKII plays a critical upstream role in mediating the effects of H 2 O 2 on ERK1/2, PKB, and IGF-1R phosphorylation.