Nitric oxide (NO) is involved in a variety of physiological processes, such as vasoregulation and neurotransmission, and has a complex role in the regulation of pain transduction and synaptic transmission. We have shown previously that NO inhibits high voltage-activated Ca 2؉ channels in primary sensory neurons and excitatory synaptic transmission in the spinal dorsal horn. However, the molecular mechanism involved in this inhibitory action remains unclear. In this study, we investigated the role of S-nitrosylation in the NO regulation of high voltage-activated Ca 2؉ channels. The NO donor S-nitroso-N-acetyl-DL-penicillamine (SNAP) rapidly reduced N-type currents when Cav2.2 was coexpressed with the Cav1 or Cav3 subunits in HEK293 cells. In contrast, SNAP only slightly inhibited P/Q-type and L-type currents reconstituted with various Cav subunits. SNAP caused a depolarizing shift in voltage-dependent N-type channel activation, but it had no effect on Cav2.2 protein levels on the membrane surface. The inhibitory effect of SNAP on N-type currents was blocked by the sulfhydryl-specific modifying reagent methanethiosulfonate ethylammonium. Furthermore, the consensus motifs of S-nitrosylation were much more abundant in Cav2.2 than in Cav1.2 and Cav2.1. Site-directed mutagenesis studies showed that Cys-805, Cys-930, and Cys-1045 in the II-III intracellular loop, Cys-1835 and Cys-2145 in the C terminus of Cav2.2, and Cys-346 in the Cav3 subunit were nitrosylation sites mediating NO sensitivity of N-type channels. Our findings demonstrate that the consensus motifs of S-nitrosylation in cytoplasmically accessible sites are critically involved in post-translational regulation of N-type Ca 2؉ channels by NO. S-Nitrosylation mediates the feedback regulation of N-type channels by NO.High voltage-activated (HVA) Ca 2ϩ channels play obligatory roles in diverse physiological functions, including regulation of gene expression, synaptic transmission, and muscle contraction. These channels are heteromeric protein complexes composed of ␣ 1 , , and ␣ 2 ␦ subunits (1, 2). The ␣ 1 subunit (Cav␣ 1 ) contains the channel pore and is the principal component of HVA Ca 2ϩ channels. Both Cav␣ 1 and cytosolic auxiliary  subunits (Cav) carry out essential gating functions (1,3,4). Cav␣ 1 has the most drug-binding sites of the subunits, whereas Cav is essential for regulating the surface expression of the channel complex (1).There exist several types of HVA Ca 2ϩ channels, including L-, N-, P/Q-, and R-types. L-type Ca 2ϩ channels are not only present in cardiac and smooth muscles but also expressed in neurons and endocrine cells where they regulate a multitude of processes, including the release of hormones and neurotransmitters and gene expression (5, 6). N-type channels are distributed in the brain and peripheral nervous system and are the major subtypes present in nociceptive dorsal root ganglion (DRG) 2 neurons (7-10). P/Q-type channels are involved in neurotransmitter release at synaptic terminals (11,12). The Cav subunits (Cav...