Granzyme B, a protease released from cytotoxic lymphocytes, has been proposed to induce target cell death by cleaving and activating the pro-apoptotic Bcl-2 family member Bid. It has also been proposed that granzyme B can induce target cell death by activating caspases directly, by cleaving caspase substrates, and/or by cleaving several non-caspase substrates. The relative importance of Bid in granzyme B-induced cell death has therefore remained unclear. Here we report that cells isolated from various tissues of Bid-deficient mice were resistant to granzyme B-induced cell death. Consistent with the proposed role of Bid in regulating mitochondrial outer membrane permeabilization, cytochrome c remained in the mitochondria of Bid-deficient cells treated with granzyme B. Unlike wild type cells, Biddeficient cells survived and were then able to proliferate normally, demonstrating the critical role for Bid in mediating granzyme B-induced apoptosis.Granzyme B is a serine protease contained within the granules of cytotoxic lymphocytes (CLs).1 Upon conjugation with their targets, CLs release their granule contents into the synaptic cleft. Granzyme B then enters the target cell by endocytosis and induces apoptotic death via a perforin-dependent mechanism. The importance of CL-mediated killing in the immune response to various pathogens has made it imperative to understand the mechanism of action of granzyme B.Overexpression of the oncogene Bcl-2 renders cells resistant to granzyme B-induced apoptosis (1, 2), and the cells maintain their ability to proliferate (2, 3). Bcl-2 is one of a large family of proteins that regulate mitochondrial outer membrane permeabilization (MOMP) during apoptosis (4). Pro-apoptotic Bcl-2 family members (such as Bid, Bax, and Bak) induce MOMP (5), whereas anti-apoptotic members (e.g. Bcl-2 and Bcl-XL) prevent MOMP (6). Following MOMP, several pro-apoptotic proteins are released from the mitochondrial intermembrane space. In the cytosol, these proteins facilitate the activation of caspases, proteases that orchestrate the death of a cell by apoptosis. One of these proteins, cytochrome c, initiates a complex with dATP, apoptotic protease-activating factor (APAF-1), and pro-caspase-9. This results in the activation of caspase-9, which in turn activates caspase-3 (7). A second protein SMAC/ Diablo that is also released from the mitochondrial intermembrane space displaces inhibitor of apoptosis proteins (IAPs) from caspases, allowing them to become activated by autoprocessing (8, 9).Granzyme B has been reported to induce MOMP by cleaving and activating the pro-apoptotic Bcl-2 family member Bid after residue [10][11][12]. Granzyme B has also been shown to cleave caspase-3 directly when mixed with cytosolic lysates (13, 14); however, in intact cells, granzyme B only appears to be capable of partially processing procaspase-3 to a p20 form that shows little activity in a cellular context (15). SMAC/Diablo, released following MOMP, then displaces the IAPs from the p20 form of caspase-3, allowing auto-proc...