The kinase Akt mediates signals from growth factor receptors for increased cell proliferation, survival, and migration, which contribute to the positive effects of Akt in cancer progression. Substrates are generally inhibited when phosphorylated by Akt; however, we show phosphorylation of the plasma membrane sodium-hydrogen exchanger NHE1 by Akt increases exchanger activity (H ؉ efflux). Our data fulfill criteria for NHE1 being a bona fide Akt substrate, including direct phosphorylation in vitro, using mass spectrometry and Akt phospho-substrate antibodies to identify Ser 648 as the Akt phosphorylation site and loss of increased exchanger phosphorylation and activity by insulin and platelet-derived growth factor in fibroblasts expressing a mutant NHE1-S648A. How Akt induces actin cytoskeleton remodeling to promote cell migration and tumor cell metastasis is unclear, but disassembly of actin stress fibers by platelet-derived growth factor and insulin and increased proliferation in growth medium are inhibited in fibroblasts expressing NHE1-S648A. We predict that other functions shared by Akt and NHE1, including cell growth and survival, might be regulated by increased H ؉ efflux.The serine/threonine kinase Akt/protein kinase B functions as a convergence site of cues that signal through the lipid kinase phosphoinositide 3-kinase (PI 3-kinase), 4 including activated integrin receptors, growth factor receptor tyrosine kinases, cytokine receptors, and G protein-coupled receptors. Akt confers signal relay from these upstream regulators to increase cell proliferation, cell survival, protein synthesis, and glycolytic flux (1). These actions contribute to the positive effects of Akt in cancer progression, and PI 3-kinase/Akt signaling is commonly aberrant in human tumors (2). Akt also regulates reorganization of the actin cytoskeleton, including disassembly of bundled actin stress fibers and formation of actin filament-rich membrane protrusions (3, 4), which likely enhance the positive effects of some Akt isoforms on cell migration (5) and tumor cell metastasis (6). However, compared with most cell processes regulated by Akt, our understanding of how Akt regulates cytoskeleton dynamics is least understood. Akt generally phosphorylates substrates at an RXRXX(S/T) recognition motif (7), and in most instances Akt phosphorylation inhibits activity or function of the substrate. Akt promotes cell proliferation by phosphorylating and inhibiting the negative cell cycle regulators p21Cip1/WAF1 (8) and p27 Kip1 (9 -11) and Wee1 kinase (12). It promotes cell survival by phosphorylating and inhibiting the function of proapoptosis regulators, including Bad (13,14) and forkhead transcription factors (15,16), and it increases protein synthesis by phosphorylating and inhibiting the negative regulators of mTOR, tubersclerosis sclerosis protein 2 (17) and proline-rich Akt substrate of 40 kDa (18). Additionally, Akt increases metabolism in part by phosphorylating and inhibiting glycogen synthase 3 (19). However, there are a few exceptions w...