The complement protein C5 initiates assembly of the membrane attack complex. This remarkable process results in lysis of target cells and is fundamental to mammalian defense against infection. The 150-amino acid residue domain at the C terminus of C5 (C5-C345C) is pivotal to C5 function. It interacts with enzymes that convert C5 to C5b, the first step in the assembly of the membrane attack complex; it also binds to the membrane attack complex components C6 and C7 with high affinity. Here a recombinant version of this C5-C345C domain is shown to adopt the oligosaccharide/oligonucleotide binding fold, with two helices packed against a five-stranded -barrel. The structure is compared with those from the netrin-like module family that have a similar fold. Residues critical to the interaction with C5-convertase cluster on a mobile, hydrophobic interstrand loop that protrudes from the open face of the -barrel. The opposite, helix-dominated face of C5-C345C carries a pair of exposed hydrophobic side chains adjacent to a striking negatively charged patch, consistent with affinity for positively charged factor I modules in C6 and C7. Modeling of homologous domains from complement proteins C3 and C4, which do not participate in membrane attack complex assembly, suggests that this provisionally identified C6/C7-interacting face is indeed specific to C5.A complement-mediated response to infection is fundamental to good health, but inappropriate complement activity underlies the symptoms of numerous inflammatory disorders (1). Activation of complement, and the ensuing attack on pathogens, entails a sequence of intermolecular recognition events, enzymatic cleavages, and assemblies of multiprotein complexes. The ϳ30 fluid-phase and membrane-associated proteins participating in the complement system have been well characterized at the sequence level, and their respective roles are broadly understood (2, 3). There is, however, little understanding at atomic resolution of the interplay between the components. In particular, the sequence in which the five soluble, terminal components of complement (C5, C6, C7, C8, and C9) assemble to form the remarkable lipid bilayer-penetrating membrane attack complex (MAC) 1 has been known for many years (4). But the network of protein-protein interactions entailed in forming this stable lytic complex and the involvement of specific amino acids remain a mystery. The key to progress in this area will be more three-dimensional structural information.Assembly of the MAC is initiated by proteolytic cleavage of C5 by the trimeric enzyme, C5 convertase, at the target cell surface to generate C5a and a metastable species, C5b. C5b has the transient ability to interact tightly with C6 (5). The C5bC6 complex subsequently serves as a nucleation site for sequential assembly of C7, C8, and n molecules of C9 to create the MAC. Mature C5 is a heterodimer consisting of ␣ and  chains of 115 and 75 kDa, respectively. It is evolutionarily related to the earlier complement components C3 and C4. Unlike the major...