Heparan sulfate, an extensively sulfated glycosaminoglycan abundant on cell surface proteoglycans, regulates intercellular signaling through its binding to various growth factors and receptors. In the lacrimal gland, branching morphogenesis depends on the interaction of heparan sulfate with Fgf10-Fgfr2b. To address if lacrimal gland development and FGF signaling depends on 2-O-sulfation of uronic acids and 6-O-sulfation of glucosamine residues, we genetically ablated heparan sulfate 2-O and 6-O sulfotransferases (Hs2st, Hs6st1, and Hs6st2) in developing lacrimal gland. Using a panel of phage display antibodies, we confirmed that these mutations disrupted 2-O and/or 6-O but not N-sulfation of heparan sulfate. The Hs6st mutants exhibited significant lacrimal gland hypoplasia and a strong genetic interaction with Fgf10, demonstrating the importance of heparan sulfate 6-O sulfation in lacrimal gland FGF signaling. Altering Hs2st caused a much less severe phenotype, but the Hs2st;Hs6st double mutants completely abolished lacrimal gland development, suggesting that both 2-O and 6-O sulfation of heparan sulfate contribute to FGF signaling. Combined Hs2st;Hs6st deficiency synergistically disrupted the formation of Fgf10-Fgfr2b-heparan sulfate complex on the cell surface and prevented lacrimal gland induction by Fgf10 in explant cultures. Importantly, the Hs2st;Hs6st double mutants abrogated FGF downstream ERK signaling. Therefore, Fgf10-Fgfr2b signaling during lacrimal gland development is sensitive to the content or arrangement of O-sulfate groups in heparan sulfate. To our knowledge, this is the first study to show that simultaneous deletion of Hs2st and Hs6st exhibits profound FGF signaling defects in mammalian development.Heparan sulfate is a cell-surface glycosaminoglycan playing important roles in the transport and signaling of multiple growth factors, including Hedgehog, Wnt, bone morphogenic protein (BMP), and fibroblast growth factor (FGF) (1-3). Heparan sulfate is first synthesized from the activated monosaccharides, UDP-glucuronic acid and UDP-N-acetylglucosamine, by an Ext copolymerase complex to form a copolymer of glucuronic acid and N-acetylglucosamine. Polymerization is followed by N-deacetylation/N-sulfation of subsets of N-acetylglucosamine residues by N-deacetylase-N-sulfotransferase (Ndst) 2 enzymes (4). Because of the incomplete processing by the Ndst enzymes, the polysaccharide backbone is divided into stretches of variable length of N-sulfated disaccharides (NS domains) and N-acetylated disaccharides (NA domains). A portion of the D-glucuronic acid residues in the NS domains is next converted by glucuronyl C5-epimerase (Hsepi) into l-iduronic acids. A 2-O-sulfotransferase (Hs2st) transfers a sulfate group to the C-2 carbon of the iduronic acids and less frequently to glucuronic acid. Finally, 6-O-sulfotransferases (Hs6st) and more rarely 3-O-sulfotransferases (Hs3st) add sulfate groups to the C-6 and C-3 carbon of the glucosamine residues, respectively. These reactions do not go to completion, lea...