Type 1 diabetes studies consistently generate data showing islet b-cell dysfunction and T cell-mediated anti-b-cell-specific autoimmunity. To explore the pathogenesis, we interrogated the b-cell transcriptomes from donors with and without type 1 diabetes using both bulk-sorted and single b-cells. Consistent with immunohistological studies, b-cells from donors with type 1 diabetes displayed increased Class I transcripts and associated mRNA species. These b-cells also expressed mRNA for Class II and Class II antigen presentation pathway components, but lacked the macrophage marker CD68. Immunohistological study of three independent cohorts of donors with recent-onset type 1 diabetes showed Class II protein and its transcriptional regulator Class II MHC trans-activator protein expressed by a subset of insulin + CD68 2 b-cells, specifically found in islets with lymphocytic infiltrates. b-Cell surface expression of HLA Class II was detected on a portion of CD45 2 insulin + b-cells from donors with type 1 diabetes by immunofluorescence and flow cytometry. Our data demonstrate that pancreatic b-cells from donors with type 1 diabetes express Class II molecules on selected cells with other key genes in those pathways and inflammation-associated genes. b-Cell expression of Class II molecules suggests that b-cells may interact directly with islet-infiltrating CD4 + T cells and may play an immunopathogenic role. The immune system plays a critical role in human type 1 diabetes pathogenesis. Varying proportions of T-cell subsets (CD8 + and CD4 +) and B cells infiltrate the pancreatic islets (1) and target b-cells by recognizing type 1 diabetes-associated autoantigens (2,3). The immunological mechanisms recruiting these cells to the islets had remained incompletely understood because, until recently, islets from donors with type 1 diabetes were not available for study. Antigen presentation to T cells is mediated by antigen-presenting cells (APCs) via two classes of HLA molecules: HLA Class I, recognized by CD8 +-expressing T cells (Class I is present on nearly all nucleated cells), and