SUMMARY The surface of neonatal rat cells in culture, neonatal rat hearts, and adult rabbit hearts have qualitatively similar responses to lanthanum, ruthenium red, and colloidal iron stains. All demonstrate a surface coat and external lamina with abundant negatively charged sites. Cells with intact surface structure do not permit entry of lanthanum (La 3+ ) intracellularly. The surface of all the myocardial cells studied contained abundant sialic acid distributed in two distinct layers, one in the surface coat next to the lipid bilayer, the other in the external lamina at the interstitial interface. The removal of sialic acid from the cellular surface increases calcium (Ca 2+ ) exchangeability 5-to 6-fold. Its removal also permits La 3+ to enter the cell and displace more than 80% of cellular Ca 2+ . Despite these marked alterations in Ca 2+ and La 3+ permeability, sialic acid removal has no effect on potassium