Nitric oxide (NO) has several essential roles in mammals, but unregulated NO production can cause cell death through oxidative stress, disrupted energy metabolism, DNA damage, activation of poly(ADP-ribose) polymerase, or dysregulation of cytosolic calcium. Such disturbances can lead to either apoptotic or necrotic cell death, depending on the severity and context of the damage. Here I review the mechanisms by which NO kills cells and discuss how NO thereby contributes to ischaemia-reperfusion injury and neurodegeneration.