Metabolites released from hypoxic tissues have recently been reported to be angiogenic, although it remains to be clarified if they have a role independent of the upregulation of hypoxia-inducible genes such as vascular endothelial growth factor (VEGF). In an attempt to conclusively evaluate their role, the metabolites lactate, pyruvate, malate and adenosine were tested in a two-dimensional in vitro angiogenesis assay which consists of human umbilical vein endothelial cells (HUVECs) co-cultured with fibroblasts of dermal origin. In addition, ethanol was tested. Metabolism of ethanol leads to increased levels of lactate and malate, which may explain its recently reported angiogenic properties. Lactate, malate, adenosine and ethanol produced a significant angiogenic response, although this was only observed at certain concentrations. However this angiogenic response was abolished when repeated in the presence of neutralising anti-VEGF antibodies. The results of this study therefore indicate that the angiogenic potential of metabolites is dependent upon increased expression of VEGF.