Continuous endothelium and epithelium create formidable barriers to endogenous molecules as well as targeted drug and gene therapies in vivo. Caveolae represent a possible vesicular trafficking pathway through cell barriers. Here we discuss recent discoveries regarding the basic function of caveolae in transport including transcellular trafficking, intracellular trafficking to distinct endosomes, and molecular mechanisms mediating their budding, docking and fusion (dynamin and SNARE machinery). New technologies to purify and map caveolae as well as generate new probes selectively targeting caveolae in vivo provide valuable tools not only for investigating caveolar endocytosis/transcytosis but also elucidating new potential applications for site-directed treatment of many diseases. Vascular targeting of the caveolar trafficking pathway may be a useful strategy for achieving tissue-specific pharmacodelivery that also overcomes key, normally restrictive cell barriers which greatly reduce the efficacy of many therapies in vivo.