The scaffolding protein at the neuromuscular junction, rapsyn, enables clustering of nicotinic acetylcholine receptors in high concentration and is critical for muscle function. Patients with insufficient receptor clustering suffer from muscle weakness. However, the detailed organization of the receptor-rapsyn network is poorly understood: it is unclear whether rapsyn first forms a wide meshwork to which receptors can subsequently dock or whether it only forms short bridges linking receptors together to make a large cluster. Furthermore, the number of rapsyn-binding sites per receptor (a heteropentamer) has been controversial. Here, we show by cryoelectron tomography and subtomogram averaging of Torpedo postsynaptic membrane that receptors are connected by up to three rapsyn bridges, the minimum number required to form a 2D network. Half of the receptors belong to rapsyn-connected groups comprising between two and fourteen receptors. Our results provide a structural basis for explaining the stability and low diffusion of receptors within clusters.cryoelectron microscopy | neurotransmitter receptor clustering | synapse | ligand-gated ion channel | tetratricopeptide repeat T he cytoplasmic protein rapsyn, also known as the 43K protein, interacts with nicotinic acetylcholine receptors in the postsynaptic membrane at the neuromuscular junction, forming clusters where receptors are present in high concentration. Such clustering is necessary for efficient neurotransmission and, hence, muscle functioning. Rapsyn-deficient mice fail to form clusters, show severe muscle weakness and breathing difficulties, and die within hours after birth (1). Furthermore, many patients suffering from congenital myasthenic syndrome are found to have mutations in rapsyn (2).Rapsyn is a 43-kDa protein containing a myristoylation site necessary for submembrane localization, seven tetratricopeptide repeats (TRPs), a putative coiled-coil domain, and a RING-H2 domain (3). Two TPRs are necessary for rapsyn self-association, whereas association with receptor depends on the predicted coiled-coil (3, 4). Rapsyn is also linked through the RING-H2 domain to dystroglycan, a protein that indirectly binds actin cytoskeleton (5). Recombinant rapsyn expressed in heterologous systems spontaneously aggregates underneath the plasma membrane (3), suggesting that rapsyn might first form a wide scaffold to which receptors can subsequently dock (6). On the other hand, rapsyn and the receptor are cotransported in membrane vesicles toward the plasma membrane, and the receptor is necessary for rapsyn clustering in C2 myotubes, raising the possibility that rapsyn only forms short bridges linking receptors together to form a large cluster (7-9). Furthermore, the number of rapsyn-binding sites per receptor (a heteropentamer) has been variously estimated to be between one and five (6, 10, 11). Therefore, the molecular details and organization of the receptor-rapsyn network are poorly understood.To address these issues, we applied cryoelectron tomography, combined with...