Reduced sperm motility (asthenospermia) and resulting infertility arise from deletion of the Plasma Membrane Ca 2+ -ATPase 4 (Pmca4) gene which encodes the highly conserved Ca 2+ efflux pump, PMCA4. This is the major Ca 2+ clearance protein in murine sperm. Since the mechanism underlying asthenospermia in PMCA4's absence or reduced activity is unknown, we investigated if sperm PMCA4 negatively regulates nitric oxide synthases (NOSs) and when absent NO, peroxynitrite, and oxidative stress levels are increased. Using co-immunoprecipitation (Co-IP) and Fluorescence Resonance Energy Transfer (FRET), we show an association of PMCA4 with the NOSs in elevated cytosolic [Ca 2+ ] in capacitated and Ca 2+ ionophore-treated sperm and with neuronal (nNOS) at basal [Ca 2+ ] (ucapacitated sperm). FRET efficiencies for PMCA4-eNOS were 35% and 23% in capacitated and uncapacitated sperm, significantly (p < 0.01) different, with the molecules being <10 nm apart. For PMCA4-nNOS, this interaction was seen only for capacitated sperm where FRET efficiency was 24%, significantly (p < 0.05) higher than in uncapacitated sperm (6%). PMCA4 and the NOSs were identified as interacting partners in a quaternary complex that includes Caveolin1, which co-immunoprecipitated with eNOS in a Ca 2+ -dependent manner. In Pmca4 −/− sperm NOS activity was elevated twofold in capacitated/uncapacitated sperm (vs. wild-type), accompanied by a twofold increase in peroxynitrite levels and significantly (p < 0.001) increased numbers of apoptotic germ cells. The data support a quaternary complex model in which PMCA4 co-ordinates Ca 2+ and NO signaling to maintain motility, with increased NO levels resulting in asthenospermia in Pmca4 −/− males.They suggest the involvement of PMCA4 mutations in human asthenospermia, with diagnostic relevance.asthenospermia, calcium efflux pump, infertility, oxidative stress, sperm damageCapacitation is the series of changes that occur in the final maturation of mammalian sperm in the female in order for them to gain fertilizing competence, and subsequently undergo the acrosome reaction. Both of these processes are dependent on elevated levels of cytosolic Ca 2+ concentration ([Ca 2+ ] c ) (de Lamirande, Leclerc, & Gagnon, 1997;Fraser, 1987). After the calcium influx required to meet this high calcium demand, there needs to be a return to resting cytosolic calcium concentration ([Ca 2+ ] c ) levels (50-100 nM [Herrick et al., 2005]). In mice, in the absence of the major calcium efflux pump, Plasma Membrane Calcium ATPase 4 (PMCA4) (Wennemuth, Babcock, & Hille, 2003), calcium levels remain elevated with loss of sperm motility (Asthenospermia, AS) and resulting male infertility (Okunade et al., 2004;Schuh et al., 2004 (de Lamirande et al., 1997;Fraser, 1987) which rapidly activates them (Knowles & Moncada, 1994). Thus, as PMCA4 extrudes Ca 2+ , the NOSs are held in a locale or microdomain with a relatively low [Ca 2+ ] c, compared to the surrounding environment where it is globally high. In this Ca 2+ -extruding locale, NO...