1. (42)K has been used to study the ouabain-sensitive component of potassium efflux from intact human red cells.2. Ouabain-sensitive efflux of potassium was observed only in media containing either sodium ions in moderate or high concentration or potassium ions.3. The effects of sodium and potassium in the medium were not additive. Potassium ions always increased the ouabain-sensitive potassium efflux, but in media containing 4.2 mM-K an increase in sodium concentration from 4.5 to 131 mM had little effect.4. In potassium-free media, ouabain-sensitive potassium efflux increased roughly linearly as the external sodium concentration was increased from 35 to 155 mM.5. The sensitivity of potassium efflux to external potassium depended on the concentration of sodium in the medium. In a 5 mM-Na (choline) medium, ouabain-sensitive potassium efflux was half-maximal at about 0.27 mM-K. In a 150 mM-Na medium the effect of potassium was half-maximal at about 1 mM-K. The relation between external potassium concentration and ouabain-sensitive sodium efflux was similarly influenced by the concentration of sodium ions in the medium.6. Inosine greatly reduced the ouabain-sensitive efflux of potassium into both 5 mM-K and potassium-free media. It probably acted by reducing the intracellular phosphate concentration to a low level.7. Ouabain-sensitive potassium efflux was not affected by the concentration of inorganic phosphate outside the cells and was not associated with a ouabain-sensitive efflux of phosphate of comparable magnitude. A small associated efflux could not be excluded.8. Simultaneous measurements of sodium efflux and of potassium efflux from identical batches of cells incubated in potassium-free media showed that inosine reduced ouabain-sensitive potassium efflux at the same time as it increased ouabain-sensitive sodium efflux.9. When cells that had been largely depleted of energy stores by pre-incubation with 2-deoxyglucose were incubated in high-sodium media, with and without potassium, it was observed that potassium in the medium increased the ouabain-sensitive potassium efflux but reduced the ouabain-sensitive efflux of sodium.10. Simultaneous measurements of the ouabain-sensitive efflux of potassium and influx and efflux of sodium across the membranes of starved cells incubated in potassium-free media, with and without inosine, suggested that ouabain-sensitive potassium efflux was associated with a net ouabain-sensitive entry of sodium.11. The results are best explained by supposing that the ouabain-sensitive efflux of potassium does not reflect lack of discrimination by the mechanism responsible for sodium expulsion, but is brought about by the reversal of steps in the pump cycle normally responsible for potassium entry.