The crystal structures of two ternary complexes of human spermine synthase (EC 2.5.1.22), one with 5-methylthioadenosine and spermidine and the other with 5-methylthioadenosine and spermine, have been solved. They show that the enzyme is a dimer of two identical subunits. Each monomer has three domains: a C-terminal domain, which contains the active site and is similar in structure to spermidine synthase; a central domain made up of four -strands; and an N-terminal domain with remarkable structural similarity to S-adenosylmethionine decarboxylase, the enzyme that forms the aminopropyl donor substrate. Dimerization occurs mainly through interactions between the N-terminal domains. Deletion of the N-terminal domain led to a complete loss of spermine synthase activity, suggesting that dimerization may be required for activity. The structures provide an outline of the active site and a plausible model for catalysis. The active site is similar to those of spermidine synthases but has a larger substrate-binding pocket able to accommodate longer substrates. Two residues (Asp 201 and Asp 276 ) that are conserved in aminopropyltransferases appear to play a key part in the catalytic mechanism, and this role was supported by the results of site-directed mutagenesis. The spermine synthase⅐5-methylthioadenosine structure provides a plausible explanation for the potent inhibition of the reaction by this product and the stronger inhibition of spermine synthase compared with spermidine synthase. An analysis to trace possible evolutionary origins of spermine synthase is also described.Polyamines are essential for normal growth and development, and the polyamine biosynthetic pathway is an important target for the design of therapeutic agents (1, 2). The predominant polyamines in mammalian cells are spermidine (SPD) 4 and spermine (SPM). These polyamines are made by the sequential addition of aminopropyl groups from decarboxylated S-adenosylmethionine (dcAdoMet). The addition of the first aminopropyl group to the diamine precursor putrescine is catalyzed by spermidine synthase (SpdSyn). The addition of a second aminopropyl group to the N-10 position 5 of SPD to form SPM is catalyzed by spermine synthase (SpmSyn) (Fig. 1). The critical importance of polyamines is demonstrated by studies using mice with gene deletions of ornithine decarboxylase (3) or S-adenosylmethionine decarboxylase (AdoMetDC) (4), both of which are lethal at the earliest stages of embryonic development. No SpdSyn knock-out mice have been described, but studies in yeast show that this gene is required for viability and that SPD plays an essential role as a precursor of hypusine formed in the post-translational modification of eukaryotic initiation factor 5A (5). SpmSyn has received relatively little attention compared with the large number of publications describing ornithine decarboxylase, AdoMetDC, and SpdSyn (1, 6 -8). The SpmSyn gene is not essential for growth of yeast (9). Mutants lacking the AdoMetDC gene, which cannot make SPD or SPM, grow normally when ...