A vehicle door opening and closing apparatus includes a rail mounted on a vehicle body, a roller unit mounted on a vehicle door, the vehicle door having a main latch releasably engaged with a main striker mounted on the vehicle body, the roller unit configured to allow the vehicle door to open and close in a sliding mode and a swing mode, and an outside handle operatively connected to the main latch, and including a handle base mounted on the vehicle door and a handle grip movably mounted on the handle base, wherein the handle grip is slidable in a longitudinal direction of the vehicle body, and pivotal in a transverse direction of the vehicle body, and wherein as the handle grip slides, the sliding mode is selected, and as the handle grip pivots, the swing mode is selected.