This review summarizes information about the specific features that are characteristic of the centrosome and its relationship with the cell function of highly specialized cells, such as endotheliocytes. It is based on data from other researchers and our own long-term experience. The participation of the centrosome in the functional activity of these cells, including its involvement in the performance of the main barrier function of the endothelium, is discussed. According to modern concepts, the centrosome is a multifunctional complex and an integral element of a living cell; the functions of which are not limited only to the ability to polymerize microtubules. The location of the centrosome near the center of the interphase cell, the concentration of various regulatory proteins in it, the organization of the centrosome radial system of microtubules through which intracellular transport is carried out by motor proteins and the involvement of the centrosome in the process of the perception of the external signals and their transmission make this cellular structure a universal regulatory and distribution center, controlling the entire dynamic morphology of an animal cell. Drawing from modern data on the tissue-specific features of the centrosome’s structure, we discuss the direct involvement of the centrosome in the performance of functions by specialized cells.