Vision-based autonomous driving shows great potential due to its satisfactory performance and low costs. Most existing methods adopt dense representations (e.g., bird's eye view) or sparse representations (e.g., instance boxes) for decision-making, which suffer from the trade-off between comprehensiveness and efficiency. This paper explores a Gaussian-centric end-to-end autonomous driving (GaussianAD) framework and exploits 3D semantic Gaussians to extensively yet sparsely describe the scene. We initialize the scene with uniform 3D Gaussians and use surrounding-view images to progressively refine them to obtain the 3D Gaussian scene representation. We then use sparse convolutions to efficiently perform 3D perception (e.g., 3D detection, semantic map construction). We predict 3D flows for the Gaussians with dynamic semantics and plan the ego trajectory accordingly with an objective of future scene forecasting. Our GaussianAD can be trained in an end-to-end manner with optional perception labels when available. Extensive experiments on the widely used nuScenes dataset verify the effectiveness of our end-to-end GaussianAD on various tasks including motion planning, 3D occupancy prediction, and 4D occupancy forecasting. Code: https://github.com/wzzheng/GaussianAD.