The inositol 1,4,5-trisphosphate (IP₃) receptors form a family of ubiquitously expressed Ca²⁺-release channels of the endoplasmic reticulum. The complex spatio-temporal Ca²⁺ signals resulting from IP₃ receptor activation in various physiological settings have been implicated in a plethora of cell functions. Since a number of years it became increasingly clear that the IP₃ receptor is also involved in cell fate decisions. Depending on the presence of various regulatory proteins, including, but not limited to, Bcl-2 family members, Beclin 1, and protein kinase B, IP₃ receptors can participate in both the regulation of apoptosis, a programmed cell death program, and of autophagy, a conserved degradation pathway, increasing cells survival after stress. The understanding of the exact mechanisms involved may in the future allow directing cell fate by modulating Ca²⁺ signalling in various pathological paradigms, including cancer and neurodegenerative diseases.