Activated leukocyte cell adhesion molecule (ALCAM/CD166) is a member of the immunoglobulin superfamily and belongs to a recent subgroup with five extracellular immunoglobulin-like domains (VVC2C2C2). ALCAM mediates both heterophilic (ALCAM-CD6) and homophilic (ALCAM-ALCAM) cell-cell interactions. While expressed in a wide variety of tissues, ALCAM is usually restricted to subsets of cells involved in dynamic growth and/or migration, including neural development, branching organ development, hematopoiesis, immune response and tumor progression. Recent structure-function analyses of ALCAM hint at how its cytoskeletal anchoring and the integrity of the extracellular immunoglobulin-like domains may regulate complex cellular properties in regard to cell adhesion, growth and migration. Accumulating evidence suggests that ALCAM expression may reflect the onset of a cellular program for homeostatic control of growth saturation, which induces either growth arrest or cell migration when the upper limits are exceeded.