Cells change their shape and mechanics dramatically during development and tissue healing in response to morphogens, cell-cell contact, adhesion to extracellular matrix, and more. Several regulatory links have been described between cell shape, cytoskeletal tension, matrix adhesiveness and stiffness, and recent studies have begun to uncover how these mechanotransduction pathways can impact transcriptional signaling and cell fate decision. The integrated mechanisms linking cell forces, form and fate are likely critical for driving normal morphogenesis, tissue development, and healing. Dysregulation of these mechanisms may also tip the scale from normal to diseased states. Here, we highlight mechanisms that alter cell shape and mechanics, and the pathways affected by these changes.