The vertebrate body plan has bilateral symmetry and left-right asymmetries that are highly conserved. The molecular pathways for left-right development are beginning to be elucidated. Several distinct mechanisms to initiate the vertebrate left-right axis have been proposed. These mechanisms appear to converge on highly conserved expression patterns of genes in the transforming growth factor-beta (TGFbeta) family of cell-cell signaling factors, nodal and lefty-2, and subsequently the expression of the transcription regulator Pitx2, in left lateral plate mesoderm. It is possible that downstream signaling pathways diverge in distinct classes of vertebrates.