The colon has large capacities for K absorption and K secretion, but its role in maintaining K homeostasis is often overlooked. For many years, passive diffusion and/or solvent drag were thought to be the primary mechanisms for K absorption in human and animal colon. However, it is now clear that apical H ,K -ATPase, in coordination with basolateral K -Cl cotransport and/or K and Cl channels operating in parallel, mediate electroneutral K absorption in animal colon. We now know that K absorption in rat colon reflects ouabain-sensitive and ouabain-insensitive apical H ,K -ATPase activities. Ouabain-insensitive and ouabain-sensitive H ,K -ATPases are localized in surface and crypt cells, respectively. Colonic H ,K -ATPase consists of α- (HKC ) and β- (HKC ) subunits which, when coexpressed, exhibit ouabain-insensitive H ,K -ATPase activity in HEK293 cells, while HKC coexpressed with the gastric β-subunit exhibits ouabain-sensitive H ,K -ATPase activity in Xenopus oocytes. Aldosterone enhances apical H ,K -ATPase activity, HKC specific mRNA and protein expression, and K absorption. Active K secretion, on the other hand, is mediated by apical K channels operating in a coordinated way with the basolateral Na -K -2Cl cotransporter. Both Ca -activated intermediate conductance K (IK) and large conductance K (BK) channels are located in the apical membrane of colonic epithelia. IK channel-mediated K efflux provides the driving force for Cl secretion, while BK channels mediate active (e.g., cAMP-activated) K secretion. BK channel expression and activity are increased in patients with end-stage renal disease and ulcerative colitis. This review summarizes the role of apical H ,K -ATPase in K absorption, and apical BK channel function in K secretion in health and disease. © 2018 American Physiological Society. Compr Physiol 8:1513-1536, 2018.