ECM is an essential component of normal and cancer stem cell niche. The ECM plays multiple roles in maintaining stem cell properties. (A) ECM anchorage restricts stem cells in the niche and thus allows them to be exposed to paracrine (stage 1) and cell–cell contact signals (not depicted) that are essential for maintaining stem cell properties. Anchorage is also important for orienting the mitotic spindle and makes it possible for stem cells to undergo asymmetric cell division (stage 2), which is essential for stem cell self-renewal and generation of daughter cells that are destined to undergo cell differentiation. The exact mechanism whereby ECM anchorage controls asymmetric cell division remains unclear, although one possibility is to allow cytoplasmic cell fate determinants to be differentially distributed between the daughter cells. The ECM also maintains stem cell properties via its many other features including its biomechanical properties such as ECM stiffness that affects cell fate determination (stage 3). (B) In the presence of abnormal ECM (pink) or loss of ECM contact, stem cell properties fail to be maintained and undergo symmetric cell division instead, leading to an overexpansion of the (cancer) stem cell pool. Abnormal changes of the ECM can also disrupt the cellular differentiation process, resulting in loss of differentiation and an increase of stem/progenitor cells.