Synaptotagmin, a synaptic vesicle protein involved in Ca 2؉ -regulated exocytosis, displayed direct high affinity interaction with neuronal sodium channels. Monoclonal antibodies directed against synaptotagmins I and II adsorbed in a concentration-dependent and -specific manner [ 3 H]saxitoxin prelabeled sodium channels extracted with detergent from nerve endings. Conversely, co-immunoprecipitation of synaptotagmin was achieved by antibodies against sodium channel subunits. Consistent with the co-immunoprecipitation assays, solubilized [ 3 H]saxitoxin-prelabeled sodium channels were trapped on immobilized maltose binding protein (MBP)-synaptotagmin I. In vitro recombinant protein assays were employed to identify the interaction site of synaptotagmin I, which was located on the cytoplasmic loop between domains I and II of the sodium channel ␣IIA subunit. The co-immunoprecipitated synaptotagmin-sodium channel complexes were found to be Ca 2؉ -dependent; this effect was mimicked by Ba 2؉ and Sr 2؉ but not Mg 2؉ . Finally the complex was shown to be distinct from the synaptotagmin-SNARE protein complex that can selectively interact with presynaptic calcium channels (N and P͞Q types). Thus, our findings demonstrate an unexpected and direct interaction between sodium channels and synaptotagmin. The Ca 2؉ -regulated association between sodium channels and a protein implicated in vesicular fusion may have intriguing consequences for the establishment and regulation of neuronal excitability. O ne of the major physiological roles of voltage-gated sodium channels is to initiate and propagate action potentials in excitable cells. In neurons, after the generation of a large transient Na ϩ current at the axon hillock͞initial segment or at the first of node Ranvier (reviewed in ref. 1), sodium channels ensure conduction along myelinated or unmyelinated fibers to nerve terminals. Sodium channels also participate in the integration of synaptic input and the modulation of firing properties and mediate the backpropagation of action potentials into the dendritic arborization, in certain types of neurons (reviewed in ref. 1). In addition, sodium channels can produce a non-inactivating Na ϩ current that only constitutes a small fraction of the total Na ϩ current but strongly affects neuronal firing properties (for a review, see ref.2).At the molecular level, sodium channels purified from rat brain nerve endings are composed of a heterotrimeric complex. The highly glycosylated ␣ subunit (260 kDa), which is the pore-forming protein, is associated noncovalently with the 1 subunit (36 kDa), and with the 2 subunit (33 kDa) via disulfide bonds (for a review, see ref.3). At least four genes encoding distinct ␣ subtypes that are mainly expressed in the central nervous system have been identified: ␣I and ␣II͞␣IIA (4, 5), ␣III (6), and ␣6 (7). In contrast, each auxiliary subunit is encoded by a single gene (8,9).In nerve terminals, the arrival of the depolarizing wave triggers the opening of presynaptic N-and P͞Q type calcium channels, produ...