Polyvinyl chloride (PVC) is an important plastic resin for construction, pipe and tubing, siding, and other uses. Exposures to vinyl chloride monomer during the early years of production resulted in an important sentinel health event: the recognition of an excess of a rare liver cancer, hepatic angiosarcoma, at facilities throughout the world. Several other syndromes, including acro-osteolysis, also have been associated with PVC, but less clearly with vinyl chloride. Extensive research ranging from large-scale epidemiologic studies to biomarker research into molecular mechanisms continues to provide valuable insight into the pathogenesis of occupational cancer.