Human vascular smooth muscle cells, derived from explants of medial smooth muscle of a fetal aorta, were grown in vitro and examined with phase and electron microscopy for characteristic morphologic features of smooth muscle cells and for the biosynthesis of connective tissue proteins. Their patterns of growth and ultrastructure were similar to those described for other species of cultured arterial smooth muscle cells. Most cells contained varying amounts of myofilaments interpersed with dense bodies, rough and smooth endoplasmic reticulum, mitochondria, various sized vesicles, lysosomes, and lipid droplets. Extracellularly, small amounts of electron-dense material and microfilaments were observed adjacent to or between the cells. The over-all morphology suggested that the smooth muscle cells were actively engaged in protein synthesis. Although we could not identify banded collagen fibrils in 10- to 14-day-old cultures by electron microscopy, the cells synthesized and secreted a collagen characterized as type I collagen. A hydroxyproline-containing protein composed of two alpha-1 and one alpha-2 chains was extracted from the cell layer. The triple helical precursor of type I collagen, procollagen, was secreted into the medium.