Malaria sporozoites have to cross the layer of sinusoidal liver cells to reach their initial site of multiplication in the mammalian host, the hepatocytes. To determine the sinusoidal cell type sporozoites use for extravasation, endothelia or Kupffer cells, we quantified sporozoite adhesion to and invasion of sinusoidal cells isolated from rat liver. In vitro invasion assays reveal that Plasmodium berghei and P. yoelii sporozoites attach to and enter Kupffer cells, but not sinusoidal endothelia. Unlike hepatocytes and other nonphagocytic cells, which are invaded in vitro only within the first hour of parasite exposure, the number of intracellular sporozoites in Kupffer cells increases for up to 12 hours. By confocal and electron microscopy, sporozoites are enclosed in a vacuole that does not colocalize with lysosomal markers. Inhibition of phagocytosis with gadolinium chloride has no effect on Kupffer cell invasion, but abolishes phagocytosis of inactivated sporozoites. Malaria-infected anopheline mosquitoes inoculate Plasmodium sporozoites into the avascular dermis and subcutaneous connective tissue of the mammalian host. 1 Within minutes after entering a blood capillary at the mosquito bite site, the sporozoites travel in the bloodstream to the liver where they invade their initial target cells, the hepatocytes. 2 The arrest of the sporozoites in the liver sinusoid is thought to be mediated by the specific binding of the major Plasmodium sporozoite surface proteins, the circumsporozoite (CS) protein and the thrombospondin-related adhesive protein, to the unique heparan sulfate proteoglycans (HSPGs) of the liver. 3-5 For example, recombinant CS protein binds to the HSPGs on the basolateral cell surface of hepatocytes in the space of Disse. This interaction occurs between the conserved regions I and II-plus of the CS protein and highly sulfated, heparin-like oligosaccharides in heparan sulfate. 6 Furthermore, recombinant CS protein is selectively removed from the bloodstream by binding to liver HSPGs, 3,6,7 a clearance mechanism also used by lipoprotein remnants. [8][9][10][11] Since P. berghei sporozoites compete with  very low density lipoprotein for binding to HSPGs, 12 it appears that malaria sporozoites utilize an existing clearance mechanism of the host for targeting the liver sinusoid.After the initial arrest in the liver sinusoid, Plasmodium sporozoites have to cross the sinusoidal cell layer prior to invasion of hepatocytes. The sinusoid is composed of fenestrated endothelial cells and interspersed with Kupffer cells. Kupffer cells are resident macrophages of the liver that are strategically positioned in the sinusoidal lumen and exhibit numerous pseudopodia. To date, the route that sporozoites use for extravasation has remained uncertain. [13][14][15] have proposed that the parasites infect hepatocytes directly by squeezing through the endothelial fenestration, although they exceed the maximum pore size of the sieve plates (0.1 m 16 ) by an order of magnitude. However, this event has never been observ...