In this chapter we will briefly review the structure of the normal airway and the extracellular matrix components from which it is composed. The role of the fibroblast/myofibroblast in maintaining this structure will be discussed, together with the evidence for their role in remodelling the airway wall in asthma and COPD. Finally we discuss the potential for pharmacological modulation of fibroblast function as a potential means of reversing the changes in airway structure in these diseases.