The coupling of cell proliferation to cell death is thought to function as a pivotal crossroad, essential to preserve normal homeostasis and to eliminate dangerous cells before they divide. Survivin is a prototype molecule at this crossroad, intercalated in protection against mitochondrial cell death and orchestrating various aspects of cell division. Dramatically exploited in cancer and an unfavorable gene signature for disease outcome, the survivin pathway has now provided tangible opportunities for targeted, rational cancer therapy. © 2004 Wiley‐Liss, Inc.