The current studies have implicated a prominent role for PACAP peptides in modulating the physiological function of cells derived from the sympathoadrenal lineage. Compared to VIP, both PACAP-27 and PACAP-38 demonstrated potent, efficacious, and sustained stimulatory effects on sympathetic neuronal NPY and catecholamine production. The differential effects of PACAP peptides on SCG NPY and catecholamine content and secretion coincided with previous studies that activated directly the sympathetic intracellular cyclic AMP-protein kinase A signaling pathway. These effects appear to be mediated primarily by PACAP1 receptor splice variants coupled to both adenylyl cyclase and phospholipase C in SCG neurons. The actions of PACAP peptides in the SCG shared many parallels with adrenal medullary chromaffin cells, suggesting diverse roles for the PACAP peptidergic system in sympathoadrenal cell development and function. Rather than solutions, these results pose additional questions for the future. What are the endogenous sources of PACAP that regulate sympathetic and adrenal function? Do PACAP peptides, like VIP, have dual roles and also act as sympathetic postganglionic neuromodulators? Are VIP/PACAP receptors expressed during SCG development? What regulates sympathetic PACAP1 receptor isoform expression and how are they differentially coupled to neuronal intracellular signaling cascades? What defines the tissue-specific responses to PACAP-27 and PACAP-38? While many of these questions are not easily approached, future studies of these issues will certainly illuminate the function of PACAP and PACAP receptors in the nervous and endocrine systems.