Studies of the development of the nematode Caenorhabditis elegans established that programmed cell death involves specific genes and proteins and that those genes and proteins act within the cells that die. This finding revealed that cell death is a fundamental and active biological process, much like cell division and cell differentiation. The characterization of genes responsible for programmed cell death in C. elegans has defined a molecular genetic pathway. This pathway is conserved evolutionarily and provides a basis for understanding programmed cell death in more complex organisms, including humans. Knowledge of the mechanisms of programmed cell death should help lead to new methods for the diagnosis and treatment of human diseases characterized by too many or too few cell deaths, including cancer.