The procaine effect on human erythrocytes was investigated by atomic force microscopy (AFM) at three procaine concentrations, about 5 x 10(-7) M, 5 x 10(-5) M and 5 x 10(-4) M. The changes in surface morphology of erythrocyte membrane bring direct evidence on the procaine effect on the cell membrane at micro- and nanometer scale. AFM images of the control erythrocytes (without procaine) showed a well defined concave (donut) shape of cells. The structure of control erythrocytes membrane is featured by closely packed nanometer size intra-membranous particles. After the incubation of the fresh blood with increasing procaine concentrations, a progressive increase in both concave depth and surface roughness of erythrocyte membrane was observed. The particles (granules) of the membrane surface increased progressively with increasing procaine concentrations. The changes in the surface morphology of erythrocyte membrane can be associated with the enlargement of surface granules, due to the aggregation of membranous particles within the cell surface, and the domain structure formation induced by procaine. A large number of moderate elevations from 25 nm to almost 40 nm in lateral size were found to be rather uniformly distributed on the surface of whole erythrocytes at low and medium procaine concentrations, respectively. At the highest procaine concentration, the granules of about 80 nm to almost 90 nm lateral size were found to form rows rather well separated. These data are in substantial agreement with the published results obtained on membrane models in the presence of procaine.