The method of voltage clamp fluorometry combined with sitedirected fluorescence labeling was used to detect local protein motions of the fully active Na ؉ ͞K ؉ -ATPase in real time under physiological conditions. Because helix M5 extends from the cytoplasmic site of ATP hydrolysis into the cation binding region, we chose the extracellular M5-M6 loop of the sheep ␣1-subunit for the insertion of cysteine residues to identify reporter positions for conformational rearrangements during the catalytic cycle. After expression of the single cysteine mutants in Xenopus oocytes and covalent attachment of tetramethylrhodamine-6-maleimide, only mutant N790C reported molecular rearrangements of the M5-M6 loop by showing large, ouabain-sensitive fluorescence changes (Ϸ5%) on addition of extracellular K ؉ . When the enzyme was subjected to voltage jumps under Na ؉ ͞Na ؉ -exchange conditions, we observed fluorescence changes that directly correlated to transient charge movements originating from the E1P-E2P transition of the transport cycle. The voltage jump-induced fluorescence changes and transient currents were abolished after replacement of Na ؉ by tetraethylammonium or on addition of ouabain, showing that conformational flexibility is impaired under these conditions. Voltage-dependent fluorescence changes could also be observed in the presence of subsaturating K ؉ concentrations. This allowed to monitor the time course of voltage-dependent relaxations into a new stationary distribution of states under turnover conditions, showing the acceleration of relaxation kinetics with increasing K ؉ concentrations. As a result, the stationary distribution between E1 and E2 states and voltage-dependent relaxation times can be determined at any time and membrane potential under Na ؉ ͞Na ؉ exchange as well as Na ؉ ͞K ؉ turnover conditions. P -type ATPases form a major class of primary active membrane transport proteins, so called because they become transiently phosphorylated on ATP hydrolysis. The most prominent member is the ubiquitously occurring Na ϩ ͞K ϩ -ATPase, which exports three Na ϩ ions and imports two K ϩ ions in each transport cycle and thereby maintains the electrochemical gradients of Na ϩ and K ϩ across the plasma membrane of most animal cells.The reaction cycle of the Na ϩ ͞K ϩ -ATPase is described in terms of the Albers-Post scheme (see Fig. 1A) (1, 2). The transduction of primary energy from ATP hydrolysis to active ion transport is brought about by conformational changes that occur for both the ␣ and  subunit of the Na ϩ ͞K ϩ -ATPase (3-6). Several approaches were undertaken to reveal Na ϩ ͞K ϩ -ATPase conformational changes by using fluorescence labeling of the native enzyme with fluorescein-5Ј-isothiocyanate, N-(p-(2-benzimidazolyl)phenyl)-maleimide and styrylpyridinium dyes like RH421 (7-12), which were limited for several reasons. Purely biochemical assays to investigate conformationdependent proteolysis patterns cannot provide time-resolved data, in the case of fluorescence labeling with styryl dyes the site of...