Vascular smooth muscle (VSM) expresses calcium/calmodulin-dependent protein kinase II (CaMKII)-delta and -gamma isoforms. CaMKII delta promotes VSM proliferation and vascular remodeling. We tested CaMKII gamma function in vascular remodeling after injury. CaMKII gamma protein decreased 90% 14 d after balloon injury in rat carotid artery. Intraluminal transduction of adenovirus encoding CaMKII gamma(c) rescued expression to 35% of uninjured controls, inhibited neointima formation (>70%), inhibited VSM proliferation (>60%), and increased expression of the cell-cycle inhibitor p21 (>2-fold). Comparable doses of CaMKII delta(2) adenovirus had no effect. Similar dynamics in CaMKII gamma mRNA and protein expression were observed in ligated mouse carotid arteries, correlating closely with expression of VSM differentiation markers. Targeted deletion of CaMKII gamma in smooth muscle resulted in a 20-fold increase in neointimal area, with a 3-fold increase in the cell proliferation index, no change in apoptosis, and a 60% decrease in p21 expression. In cultured VSM, CaMKII gamma overexpression induced p53 mRNA (1.7 fold) and protein (1.8-fold) expression; induced the p53 target gene p21 (3-fold); decreased VSM cell proliferation (>50%); and had no effect on expression of apoptosis markers. We conclude that regulated CaMKII gamma isoform composition is an important determinant of the injury-induced vasculoproliferative response and that CaMKII gamma and -delta isoforms have nonequivalent, opposing functions.