Vitamin K2 has been shown to exert remarkable anticancer activity. However, the detailed mechanism remains unclear. Here, our study was the first to show that Vitamin K2 significantly promoted the glycolysis in bladder cancer cells by upregulating glucose consumption and lactate production, whereas inhibited TCA cycle by reducing the amounts of Acetyl-CoA. Moreover, suppression of PI3K/ AKT and HIF-1α attenuated Vitamin K2-increased glucose consumption and lactate generation, indicating that Vitamin K2 promotes PI3K/AKT and HIF-1α-mediated glycolysis in bladder cancer cells. Importantly, upon glucose limitation, Vitamin K2-upregulated glycolysis markedly induced metabolic stress, along with AMPK activation and mTORC1 pathway suppression, which subsequently triggered AMPK-dependent autophagic cell death. Intriguingly, glucose supplementation profoundly abrogated AMPK activation and rescued bladder cancer cells from Vitamin K2-triggered autophagic cell death. Furthermore, both inhibition of PI3K/AKT/HIF-1α and attenuation of glycolysis significantly blocked Vitamin K2-induced AMPK activation and subsequently prevented autophagic cell death. Collectively, these findings reveal that Vitamin K2 could induce metabolic stress and trigger AMPK-dependent autophagic cell death in bladder cancer cells by PI3K/AKT/HIF-1α-mediated glycolysis promotion. Cancer cells, including bladder carcinoma cells, display the altered metabolism, compared to normal cells 1. One of the most metabolic shifts in cancer cells is the aberrant glucose metabolism. Unlike the normal cells, most cancer cells exhibit the remarkably increased glucose uptake and glycolysis rate to meet their rapid proliferation and metastasis 2. Moreover, numerous studies indicate that the glycolysis is usually uncoupled from the tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OXPHOS) in cancer cells. Therefore, pyruvate, the end product of glycolysis, is mainly diverted to lactate production, with the reduction of mitochondrial TCA cycle and OXPHOS 3. This metabolic shift is well-known as the Warburg effect. However, in tumor microenvironment, the nutrients including glucose are limited. Excessively increasing glycolysis will inevitably result in intracellular metabolic stress and trigger cancer cell death due to energy depletion 4. Therefore, in nutrient-deficient tumor microenvironment, the method of promoting glycolysis to induce metabolic stress and activate cell death appears to be a novel strategy for cancer treatment. Phosphatidylinositide-3-kinase (PI3K) and AKT are usually hyper-activated in cancer cells. There are accumulating evidences indicating that activation of PI3K and AKT plays a pivotal role in the regulation of aerobic glycolysis in cancer cells 5-7. The activated PI3K/AKT can directly promote the shift to the aerobic glycolysis, rendering cancer cells more reliance on glucose consumption for lactate generation 8,9. Although activation of PI3K and AKT could directly stimulate the aerobic glycolysis by positive regulation of some glycol...