In addition to having a major role in energy homeostasis, leptin is emerging as a pleiotropic cytokine with multiple physiological effector functions. The recently discovered proangiogenic activity of leptin suggested the hypothesis that its production might be regulated by hypoxia, as are other angiogenic factors. To examine this proposal, the expression of leptin protein and mRNA was measured and found to be markedly up-regulated in response to ambient or chemical hypoxia (upon exposure to desferrioxamine or cobalt chloride), an effect that requires intact RNA synthesis, suggesting a transcriptional mechanism. Transient transfection of cultured cells with deletion constructs of the leptin gene promoter linked to a reporter gene revealed a functional hypoxia response element (HRE) located at position -116 within the proximal upstream region. This putative HRE harbors a characteristic 5-RCGTG-3 core motif, a hallmark of hypoxia-sensitive genes and recognized by the hypoxia-inducible factor 1 (HIF1), which consists of a HIF1␣/HIF heterodimer. Constructs harboring this -116/HRE supported reporter gene expression in response to hypoxia but not when mutated. Expression of HIF1␣ cDNA in normoxic cells mimicked hypoxia-induced reporter gene expression in cells cotransfected with the wild type leptin -116/HRE construct but not with the mutant. Gel shift assays with a 32 P-labeled leptin promoter -116/HRE probe and nuclear extracts from hypoxia-treated cells indicated binding of the HIF1␣/ heterodimer, which was blocked with an excess of unlabeled -116/HRE probe or a HIF1-binding probe from the erythropoietin gene enhancer. Taken together, these observations demonstrate that the leptin gene is actively engaged by hypoxia through a transcriptional pathway commonly utilized by hypoxia-sensitive genes.Physiological mechanisms that ensure an appropriate level of oxygen (O 2 ) delivery to tissues have evolved in complex multicellular organisms. Virtually all cells are capable of sensing changes in O 2 tension (pO 2 ) and respond adaptively when the O 2 demand exceeds supply, a condition referred to as hypoxia (1). Hypoxia can develop as a result of ischemia resulting from hypoperfusion, either as a pathological condition or as a transient physiological event (1). Under chronic conditions of hypoxia, typical adaptation responses generally include changes in the expression of genes encoding molecules that facilitate O 2 delivery or by activating metabolic pathways that do not require O 2 , thus maintaining energy homeostasis when O 2 availability is limited (1, 2). For example, hypobaric hypoxia leads to a classical response characterized by increased red blood cell mass formation after induction of the erythropoietin (Epo) 1 gene, whose expression is elevated markedly under these conditions (3, 4). In addition, the vasodilators nitric oxide and carbon monoxide are generated by the catalytic activity of inducible nitric oxide and heme oxygenase-1, respectively; expression of the genes encoding these enzymes is induced readil...