Escape from the host erythrocyte by the invasive stage of the malaria parasite Plasmodium falciparum is a fundamental step in the pathogenesis of malaria of which little is known. Upon merozoite invasion of the host cell, the parasite becomes enclosed within a parasitophorous vacuole, the compartment in which the parasite undergoes growth followed by asexual division to produce 16 -32 daughter merozoites. These daughter cells are released upon parasitophorous vacuole and erythrocyte membrane rupture. To examine the process of merozoite release, we used P. falciparum lines expressing green fluorescent protein-chimeric proteins targeted to the compartments from which merozoites must exit: the parasitophorous vacuole and the host erythrocyte cytosol. This allowed visualization of merozoite release in live parasites. Herein we provide the first evidence in live, untreated cells that merozoite release involves a primary rupture of the parasitophorous vacuole membrane followed by a secondary rupture of the erythrocyte plasma membrane. We have confirmed, with the use of immunoelectron microscopy, that parasitophorous vacuole membrane rupture occurs before erythrocyte plasma membrane rupture in untransfected wild-type parasites. We have also demonstrated selective inhibition of each step in this two-step process of exit using different protease inhibitors, implicating the involvement of distinct proteases in each of these steps. This will facilitate the identification of the parasite and host molecules involved in merozoite release.During the erythrocytic phase of the Plasmodium falciparum life cycle, the merozoites released initially from infected hepatocytes attach to and invade human erythrocytes in the bloodstream. Upon invasion of the host cell, the parasites become enclosed in a parasitophorous vacuole in which, as ring and trophozoite stages, they undergo growth followed by asexual division (schizogony) to produce 16 -32 daughter merozoites. Newly formed merozoites in the schizont must escape from both this vacuole and the host erythrocyte.Although little is known about the molecules that mediate this process, proteases have been implicated in both parasite exit from the erythrocyte and the subsequent invasion into erythrocytes through the use of protease inhibitors that halt these processes (1-3). After the demonstration that P. knowlesi schizonts incubated in the presence of the protease inhibitors chymostatin and leupeptin show decreased reinvasion caused by inhibition of schizont maturation (3, 4), Lyon and Haynes (2) demonstrated that P. falciparum schizonts cultured in the presence of the inhibitors chymostatin, leupeptin, antipain, and pepstatin also fail to rupture properly. Recently, it has been demonstrated that the protease inhibitors E-64 and E-64d inhibit schizont maturation (5, 6). The role of the proteases involved in schizont rupture is presumably to degrade both the parasitophorous vacuole and the erythrocyte membrane skeleton, thereby facilitating release. However, the proteases involved have no...