The bifunctional leukotriene B 4 12-hydroxydehydrogenase/15-oxo-prostaglandin 13-reductase (LTB 4 12-HD/ PGR) is an essential enzyme for eicosanoid inactivation. It is involved in the metabolism of the E and F series of 15-oxo-prostaglandins (15-oxo-PGs), leukotriene B 4 (LTB 4 ), and 15-oxo-lipoxin A 4 (15-oxo-LXA 4 ). Some nonsteroidal anti-inflammatory drugs (NSAIDs), which primarily act as cyclooxygenase inhibitors also inhibit LTB 4 12-HD/PGR activity. Here we report the crystal structure of the LTB 4 12-HD/PGR, the binary complex structure with NADP ؉ , and the ternary complex structure with NADP ؉ and 15-oxo-PGE 2 . In the ternary complex, both in the crystalline form and in solution, the enolate anion intermediate accumulates as a brown chromophore. PGE 2 contains two chains, but only the -chain of 15-oxo-PGE 2 was defined in the electron density map in the ternary complex structure. The -chain was identified at the hydrophobic pore on the dimer interface. The structure showed that the 15-oxo group forms hydrogen bonds with the 2-hydroxyl group of nicotine amide ribose of NADP ؉ and a bound water molecule to stabilize the enolate intermediate during the reductase reaction. The electron-deficient C13 atom of the conjugated enolate may be directly attacked by a hydride from the NADPH nicotine amide in a stereospecific manner. The moderate recognition of 15-oxo-PGE 2 is consistent with a broad substrate specificity of LTB 4 12-HD/PGR. The structure also implies that a Src homology domain 3 may interact with the left-handed prolinerich helix at the dimer interface and regulate LTB 4 12-HD/PGR activity by disruption of the substrate binding pore to accommodate the -chain.Eicosanoids, such as prostaglandins, leukotrienes, and lipoxins, are endogenous lipid mediators and play key roles in a wide range of normal physiological and pathophysiological processes such as host defense responses and inflammation. The dominant eicosanoids, leukotriene B 4 (LTB 4 ), 1 prostaglandin E and F (PGE and PGF), and lipoxin A 4 (LXA 4 ) are rapidly inactivated by enzymatic degradation. A bifunctional LTB 4 12-hydroxydehydrogenase/15-oxo-prostaglandin 13-reductase (LTB 4 12-HD/PGR), a member of the zinc-independent medium chain dehydrogenase/reductase (MDR) family (1), is a key enzyme in the irreversible degradation of all three eicosanoids to remove these highly biologically active agents (2-4) (Fig. 1).PGE 2 mediates a wide range of physiological processes in a variety of tissues (Fig. 1). It is involved in the relaxation of smooth muscle cells to protect against lung inflammation (5), regulating gastric acid and mucus secretion in the stomach (6), regulating water and mineral balance in the kidney (7), as well as having roles in immune responses, thermo-regulation, and vasopermeability. Overproduction of PGE 2 induces inflammation and can have oncogenic effects (8). PGE 2 production can be inhibited by nonsteroidal anti-inflammatory drugs (NSAIDs), which act as cyclooxygenase inhibitors. NSAIDs are important drugs in the treat...