Most excitatory synapses in the brain are made on spines, small protrusions from dendrites that exist in many different shapes and sizes. Spines are highly motile, a process that reflects rapid rearrangements of the actin cytoskeleton inside the spine, and can also change shape and size over longer timescales. These different forms of morphological plasticity are regulated in an activity-dependent way, involving calcium influx through glutamate receptors and voltage-gated calcium channels. Many proteins regulating the turnover of filamentous actin (F-actin) are calcium-dependent and might transduce intracellular calcium levels into spine shape changes. On the other hand, the morphology of a spine might affect the function of the synapse residing on it. In particular, the induction of synaptic plasticity is known to require large elevations in the postsynaptic calcium concentration, which depend on the ability of the spine to compartmentalize calcium. Since the actin cytoskeleton is also known to anchor postsynaptic glutamate receptors, changes in the actin polymerization state have the potential to influence synaptic function in a number of ways. Here we review the most prominent types of changes in spine morphology in hippocampal pyramidal cells with regard to their calcium-dependence and discuss their potential impact on synaptic function.